Introduction

Our aim was to assess impact of frailty on short-term clinical outcomes in critically ill patients with cancer.

Materials and methods

We conducted a cohort study at a medical and surgical intensive care unit (ICU) in Argentina. We included 269 consecutive patients, ≥18 years old, with diagnosis of cancer. We recorded demographic and clinical characteristics, Clinical Frailty Scale (CFS, ≥5 defined a patient as frail), and the number and duration of organ support therapies during ICU stay. Primary outcome was ICU and hospital mortality.

Results

Median age 69 (range 20–90); 152 (56%) patients were male. Sixty-eight (25.2%) patients presented frailty at admission. Older adults (≥65 years old) made up 62.8% of patients. Frail patients were 69.7 years versus 64.4 years for non-frail, P = 0.007, with higher Acute Physiology and Chronic Health Evaluation II (APACHE II) 14.7 ± 7 versus 10.8 ± 6, P = 0.001 and Simplified Acute Physiology Score (SAPS II) 40.1 ± 17 versus 28.7 ± 14, P = 0.001, respectively. After adjusting by age, severity score, type of admission, and type of cancer, frailty was independently associated with hospital mortality, odds ratio (OR) 4.87 (95% confidence interval [CI], 2.19–11.19, P ≤0.001). Median ICU length of stay was five days (interquartile range [IQR] 3–7) versus six days (IQR 3.8–9), in non-frail versus frail patients, respectively (P = 0.100), and hospital stay was nine days (IQR 6–17) versus 11.5 days (IQR 7–19.5) in non-frail versus frail patients, respectively (P = 0.085).

Discussion

Frailty as a medical condition was strongly associated with worse clinical outcomes among oncologic critically ill patients.

中文翻译：

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危重癌症患者的衰弱和临床结局：一项队列研究

介绍

我们的目的是评估衰弱对危重癌症患者的短期临床结果的影响。

材料和方法

我们在阿根廷的一家内科和外科重症监护病房 (ICU) 进行了队列研究。我们纳入了 269 名年龄≥18 岁且诊断为癌症的连续患者。我们记录了人口统计学和临床​​特征、临床虚弱量表（CFS，≥5 定义患者虚弱），以及 ICU 住院期间器官支持治疗的次数和持续时间。主要结果是 ICU 和住院死亡率。

结果

中位年龄 69 岁（范围 20-90 岁）；152 名 (56%) 患者为男性。68 名 (25.2%) 患者在入院时表现虚弱。老年人（≥65岁）占患者的62.8%。虚弱患者为 69.7 岁，非虚弱患者为 64.4 岁，P  = 0.007，具有更高的急性生理学和慢性健康评估 II (APACHE II) 14.7 ± 7 对比 10.8 ± 6，P = 0.001 和简化急性生理学评分 (SAPS II) 40.1 ± 17 与 28.7 ± 14，P = 0.001，分别。在根据年龄、严重程度评分、入院类型和癌症类型进行调整后，虚弱与住院死亡率独立相关，比值比 (OR) 为 4.87（95% 置信区间 [CI]，2.19–11.19，P ≤ 0.001）。中位 ICU 住院时间分别为 5 天（四分位间距 [IQR] 3-7）和 6 天（IQR 3.8-9），在非体弱患者和体弱患者中分别为（P  = 0.100），住院时间为 9 天（ IQR 6-17) 与 11.5 天 (IQR 7-19.5) 在非体弱患者和体弱患者中分别 ( P  = 0.085)。

讨论

虚弱作为一种医学状况与肿瘤危重患者较差的临床结果密切相关。