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Intensive Care Medicine

, Volume 33, Issue 11, pp 2009–2013 | Cite as

Outcomes and prognostic factors in patients with head and neck cancer and severe acute illnesses

  • Márcio SoaresEmail author
  • Jorge I. F. Salluh
  • Luisa Toscano
  • Fernando L. Dias
Brief Report

Abstract

Objectives

To evaluate the outcomes of patients with head and neck cancer and severe acute illnesses, and to identify characteristics associated with hospital mortality.

Design

Cohort study.

Setting

Ten-bed medical–surgical oncologic intensive care unit (ICU).

Patients

Consecutive patients admitted to the ICU over a 68-month period.

Interventions

None.

Measurements and results

Demographic, clinical and cancer-related data were collected. Multivariate logistic regression analysis was performed to identify predictive factors of hospital mortality. One hundred and twenty-one patients aged 63.3 ± 14.7 years were enrolled in the study. The main sites of primary tumor were oral cavity (30%), larynx (25%), pharynx (14%) and thyroid (9%). The main reasons for ICU admission were sepsis (37%) and acute respiratory failure (20%). The mean SAPS II score was 49.6 ± 17.8 points, and during ICU stay 100 (83%) patients received mechanical ventilation, 70 (58%), vasopressors, and 12 (10%), dialysis. The ICU, hospital and 6-month mortality rates were 39%, 56% and 72%, respectively. A performance status ≥ 2 [odds ratio (OR) = 5.17 (95% confidence interval, CI = 1.84–14.53)], advanced cancer (TNM stage IV) [OR = 3.80 (95% CI = 1.28–11.28)], and the number of organ failures [OR=2.87 (95% CI=1.83–4.50)] were associated with increased mortality in multivariate analysis.

Conclusions

In conjunction with clinical judgment and taking into consideration the patient's preferences and values, the knowledge of these outcome predictors may be useful in helping physicians to identify patients who might benefit from the intensive care and to improve discussions on patients' prognosis.

Keywords

Head and neck cancer Intensive care Mortality Outcome Critically ill 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Márcio Soares
    • 1
    Email author
  • Jorge I. F. Salluh
    • 1
  • Luisa Toscano
    • 1
  • Fernando L. Dias
    • 2
  1. 1.Intensive Care Unit, Centro de Tratamento IntensivoInstituto Nacional de Câncer–INCARio de JaneiroBrazil
  2. 2.Department of Head and Neck SurgeryInstituto Nacional de CâncerRio de JaneiroBrazil

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