Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study
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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.
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.
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.
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.
KeywordsCritically ill patient Long-term outcomes Hematological malignancy Solid tumor Quality of life
The authors wishes to thank the study nurses Patrick De Baets, Patsy Priem, Jo Vandenbossche, and Daniella Van der Jeught for their tremendous help, motivation, and enthusiasm concerning inclusions, interviewing patients, and calling patients or relatives. They thank Dominique Vandijck, who did a great job in helping with the start-up and preparation of the study, inclusions of patients, calling relatives, and supervising data collection, while working on his PhD. The authors also thank Chris Danneels for his help in setting up the database. Dominique D. Benoit received a Senior Clinical Investigator grant from the Research Foundation Flanders, Belgium.
Conflicts of interest
The authors declare that they have no competing interests.
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