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Type: Journal article
Title: Assessment of outcome over a 10-year period of patients admitted to a multidisciplinary adult intensive care unit with haematological and solid tumours
Author: Moran, J.
Solomon, P.
Williams, P.
Citation: Anaesthesia and Intensive Care, 2005; 33(1):26-35
Publisher: Australian Soc Anaesthetists
Issue Date: 2005
ISSN: 0310-057X
Statement of
J. L. Moran, P. J. Solomon, P. J. Williams
Abstract: The risk factors for time to mortality, censored at 30 days, of patients admitted to an adult teaching hospital ICU with haematological and solid malignancies were assessed in a retrospective cohort study. Patients, demographics and daily ICU patient data, from admission to day 8, were identified from a prospective computerised database and casenote review in consecutive admissions to ICU with haematological and solid tumours over a 10 year period (1989-99). The cohort, 108 ICU admissions in 89 patients was of mean age (+/-SD) 55+/-14 years; 43% were female. Patient diagnoses were leukaemia (35%), lymphoma (38%) and solid tumours (27%). Median time from hospital to ICU admission was five days (range 0-67). On ICU admission, 50% had septic shock and first day APACHE II score was 28+/-9. Forty six per cent of patients were ventilated. ICU and 30 day mortality were 39% and 54% respectively. Multivariate Cox model predictors (P<0.05), using only ICU admission day data were: Charlson comorbidity index (CCI), time to ICU admission (days) and mechanical ventilation. For daily data (admission through day 8), predictors were: cohort effect (2nd vs 1st five year period); CCI; time to ICU admission (days); APACHE II score and mechanical ventilation. Outcomes were considered appropriate for severity of illness and demonstrated improvement over time. Ventilation was an independent outcome determinant. Controlling for other factors, mortality has improved over time (1st vs 2nd five year period). Analysis restricted to admission data alone may be insensitive to particular covariate effects.
Keywords: Humans; Neoplasms; Hematologic Neoplasms; Treatment Outcome; Respiration, Artificial; Length of Stay; APACHE; Medical Records Systems, Computerized; Proportional Hazards Models; Risk Factors; Survival Analysis; Retrospective Studies; Middle Aged; Intensive Care Units; South Australia; Female; Male
Description: Publisher's copy made available with the permission of the publisher © Australian Society of Anaesthetists
RMID: 0020052690
DOI: 10.1177/0310057x0503300105
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Anaesthesia and Intensive Care publications

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