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Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study

S. G. Oeyen| D. D. Benoit| L. Annemans| P. O. Depuydt| S. J. Van Belle| R. I. Troisi| L. A. Noens| P. Pattyn| J. M. Decruyenaere
Original
Volume 39, Issue 5 / May , 2013

Pages 889 - 898

Abstract

Purpose

Data concerning long-term outcomes and quality of life (QOL) in critically ill cancer patients are scarce. The aims of this study were to assess long-term outcomes and QOL in critically ill patients with hematological (HM) or solid malignancies (SM) 3 months and 1  year after intensive care unit (ICU) discharge, to compare these with QOL before ICU admission, and to identify prognostic indicators of long-term QOL.

Methods

During a 1 year prospective observational cohort analysis, consecutive patients with HM or SM admitted to the medical or surgical ICU of a university hospital were screened for inclusion. Cancer data, demographics, co-morbidity, severity of illness, organ failures, and outcomes were collected. The QOL before ICU admission, 3 months, and 1 year after ICU discharge was assessed using standardized questionnaires (EuroQoL-5D, Medical Outcomes Study 36-item Short Form Health Survey). Statistical significance was attained at P < 0.05.

Results

There were 483 patients (85 HM, 398 SM) (64 % men) with a median age of 62 years included. Mortality rates of HM compared to SM were, respectively: hospital (34 vs. 13 %), 3 months (42 vs. 17 %), and 1 year (66 vs. 36 %) (P < 0.001). QOL declined at 3 months, but improved at 1 year although it remained under baseline QOL, particularly in HM. Older age (P = 0.007), severe comorbidity (P = 0.035), and HM (P = 0.041) were independently associated with poorer QOL at 1 year.

Conclusions

Long-term outcomes and QOL were poor, particularly in HM. Long-term expectations should play a larger role during multidisciplinary triage decisions upon referral to the ICU.

Keywords

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