Dados do Trabalho

Título

Prognostic Insights in Critically Ill Oncology Patients: Unveiling Mortality Predictors To assess the clinical profile, severity, and outcomes of oncology patients admitted to the ICU.

Objetivo

To evaluate the clinical characteristics, severity, and outcomes of oncology patients admitted to the ICU.

Métodos

This cohort study included oncology patients over 18 years old admitted to a private ICU in João Pessoa, Brazil, in 2023.

Resultados

A total of 146 oncology patients were admitted, with a median age of 73 years; 65.1% were over 65 years old, and 56.2% were female. Hematologic malignancies were rare (2.7%), while 27% had metastatic disease. Most admissions were medical (82.9%) and from the Emergency Department (77.4%), with 50.7% presenting with sepsis. The cohort had a high prevalence of frailty (MFI score 0.18), organ dysfunction (SOFA score 3), and severe illness (SAPS3 score 48). The Charlson Comorbidity Index (CCI) median was 1. The ICU mortality rate was 7.5%, with a median ICU stay of 2 days; 17.1% stayed longer than 7 days. Non-survivors had significantly higher MFI (0.27 vs. 0.09), CCI (4 vs. 1), and SAPS3 (68 vs. 46) scores (all p<0.001). Each point increase in SAPS3 corresponded to a 15.4% increase in mortality risk (OR 1.154, p=0.025). The SAPS3 had an AUC-ROC of 0.881, and the CCI had 0.811, both indicating strong predictive power for mortality.

Conclusão

This study underscores the predominance of elderly, frail oncology patients in the ICU, where higher SAPS3 and CCI scores were strongly associated with mortality. The SAPS3 score, in particular, showed excellent accuracy in predicting mortality, highlighting its importance in clinical decision-making.