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Master Thesis

Facteurs associés à la survie chez les patients atteints d'un cancer solide sortant vivant de réanimation entre 2005 et 2013

Abstract : Introduction: At intensive care unit (ICU) admission, the prognosis after ICU discharge of patients with cancer is an important but difficult issue. Our objective was to assess the factors associated with 3 and 6 month survival of ICU cancer survivors. Methods: Based on the French OutcomeRea™ database, we included solid cancer patients discharged alive, between December 2005 and November 2013, from the medical ICU of the University Hospital in Grenoble, France. Results: Of the 361 cancer patients with unscheduled admissions, 253 (70%) were discharged alive from ICU. The main primary cancer sites were digestive (31%) and thoracic (26%). The 3 and 6 month mortality rates were 33% and 41%, respectively. Factors independently associated with 6 month mortality included Eastern Cooperative Oncology Group performance status (ECOG-PS) of 3–4 (OR: 3.71; 95%CI: 1.67–8.23), metastatic disease (OR: 2.24; 95%CI: 1.22–4.09), admission for cancer progression (OR: 2.64; 95%CI: 1.32–5.30), high simplified acute physiologic score II (SAPS II) of 45 to 58 (OR: 4.41; 95%CI: 1.85–10.53), and treatment limitation decision at ICU admission (OR: 3.89; 95%CI: 1.60–9.43). About the patients with an ECOG-PS 0–1 at admission, 61% (n=57) displayed an ECOG-PS 0–2 at 6 months. At 3 months, 74 (55%) patients received anticancer treatment, with 13 (8%) given exclusive palliative care. Conclusion: The factors associated with 6 month mortality were almost the same as those known to be associated with ICU mortality. We have highlighted that most patients recovered an good ECOG-PS at 6 months and could benefit from an anticancer treatment following ICU discharge.
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Master Thesis
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Submitted on : Monday, November 4, 2019 - 3:27:49 PM
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Hubert Gheerbrant. Facteurs associés à la survie chez les patients atteints d'un cancer solide sortant vivant de réanimation entre 2005 et 2013. Médecine humaine et pathologie. 2019. ⟨dumas-02345525⟩



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