Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data

Michaël Darmon; Aurélie Bourmaud; Quentin Georges; Marcio Soares; Kyeongman Jeon; Sandra Oeyen; Chin Kook Rhee; Pascale Gruber; Marlies Ostermann; Quentin A. Hill; Pieter Depuydt; Christelle Ferra; Anne Claire Toffart; Peter Schellongowski; Alice Müller; Virginie Lemiale; Djamel Mokart; Elie Azoulay

doi:10.1007/s00134-019-05653-7

Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data

Michaël Darmon^*, Aurélie Bourmaud, Quentin Georges, Marcio Soares, Kyeongman Jeon, Sandra Oeyen, Chin Kook Rhee, Pascale Gruber, Marlies Ostermann, Quentin A. Hill, Pieter Depuydt, Christelle Ferra, Anne Claire Toffart, Peter Schellongowski, Alice Müller, Virginie Lemiale, Djamel Mokart, Elie Azoulay

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

115 Citations (Scopus)

Abstract

Purpose: The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia. Methods: Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology. Datasource: Pubmed and Cochrane databases. Eligibility criteria: Adult studies published in English between May 2005 and May 2015. Results: Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004–2010; range 1994–2012) and median number of admissions per year was 693 (IQR 450–1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93–0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95–0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients. Conclusion: After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.

Original language	English
Pages (from-to)	977-987
Number of pages	11
Journal	Intensive Care Medicine
Volume	45
Issue number	7
Early online date	29 May 2019
DOIs	https://doi.org/10.1007/s00134-019-05653-7
Publication status	Published - Jul 2019

Keywords

Hematologic neoplasms
Intensive care units
Mechanical ventilation
Neutropenia
Outcomes
Prognosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00134-019-05653-7

Cite this

Darmon, M., Bourmaud, A., Georges, Q., Soares, M., Jeon, K., Oeyen, S., Rhee, C. K., Gruber, P., Ostermann, M., Hill, Q. A., Depuydt, P., Ferra, C., Toffart, A. C., Schellongowski, P., Müller, A., Lemiale, V., Mokart, D., & Azoulay, E. (2019). Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data. Intensive Care Medicine, 45(7), 977-987. https://doi.org/10.1007/s00134-019-05653-7

@article{b7363814c4d64848ab954c86ff88889a,

title = "Changes in critically ill cancer patients{\textquoteright} short-term outcome over the last decades: results of systematic review with meta-analysis on individual data",

abstract = "Purpose: The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia. Methods: Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology. Datasource: Pubmed and Cochrane databases. Eligibility criteria: Adult studies published in English between May 2005 and May 2015. Results: Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004–2010; range 1994–2012) and median number of admissions per year was 693 (IQR 450–1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93–0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95–0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients. Conclusion: After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.",

keywords = "Hematologic neoplasms, Intensive care units, Mechanical ventilation, Neutropenia, Outcomes, Prognosis",

author = "Micha{\"e}l Darmon and Aur{\'e}lie Bourmaud and Quentin Georges and Marcio Soares and Kyeongman Jeon and Sandra Oeyen and Rhee, {Chin Kook} and Pascale Gruber and Marlies Ostermann and Hill, {Quentin A.} and Pieter Depuydt and Christelle Ferra and Toffart, {Anne Claire} and Peter Schellongowski and Alice M{\"u}ller and Virginie Lemiale and Djamel Mokart and Elie Azoulay",

year = "2019",

month = jul,

doi = "10.1007/s00134-019-05653-7",

language = "English",

volume = "45",

pages = "977--987",

journal = "Intensive Care Medicine",

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Darmon, M, Bourmaud, A, Georges, Q, Soares, M, Jeon, K, Oeyen, S, Rhee, CK, Gruber, P, Ostermann, M, Hill, QA, Depuydt, P, Ferra, C, Toffart, AC, Schellongowski, P, Müller, A, Lemiale, V, Mokart, D & Azoulay, E 2019, 'Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data', Intensive Care Medicine, vol. 45, no. 7, pp. 977-987. https://doi.org/10.1007/s00134-019-05653-7

TY - JOUR

T1 - Changes in critically ill cancer patients’ short-term outcome over the last decades

T2 - results of systematic review with meta-analysis on individual data

AU - Darmon, Michaël

AU - Bourmaud, Aurélie

AU - Georges, Quentin

AU - Soares, Marcio

AU - Jeon, Kyeongman

AU - Oeyen, Sandra

AU - Rhee, Chin Kook

AU - Gruber, Pascale

AU - Ostermann, Marlies

AU - Hill, Quentin A.

AU - Depuydt, Pieter

AU - Ferra, Christelle

AU - Toffart, Anne Claire

AU - Schellongowski, Peter

AU - Müller, Alice

AU - Lemiale, Virginie

AU - Mokart, Djamel

AU - Azoulay, Elie

PY - 2019/7

Y1 - 2019/7

N2 - Purpose: The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia. Methods: Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology. Datasource: Pubmed and Cochrane databases. Eligibility criteria: Adult studies published in English between May 2005 and May 2015. Results: Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004–2010; range 1994–2012) and median number of admissions per year was 693 (IQR 450–1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93–0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95–0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients. Conclusion: After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.

AB - Purpose: The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia. Methods: Systematic review and meta-analysis of individual data according to the guidelines of meta-analysis of observational studies in epidemiology. Datasource: Pubmed and Cochrane databases. Eligibility criteria: Adult studies published in English between May 2005 and May 2015. Results: Overall, 7354 patients were included among whom 1666 presented with neutropenia at ICU admission. Median ICU admission year was 2007 (IQR 2004–2010; range 1994–2012) and median number of admissions per year was 693 (IQR 450–1007). Overall mortality was 47.7%. ICU admission year was associated with a progressive decrease in hospital mortality (OR per year 0.94; 95% CI 0.93–0.95). After adjustment for confounders, year of ICU admission was independently associated with hospital mortality (OR for hospital mortality per year: 0.96; 95% CI 0.95–0.97). The association was also seen in patients with neutropenia but not in allogeneic stem cell transplant recipients. Conclusion: After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.

KW - Hematologic neoplasms

KW - Intensive care units

KW - Mechanical ventilation

KW - Neutropenia

KW - Outcomes

KW - Prognosis

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U2 - 10.1007/s00134-019-05653-7

DO - 10.1007/s00134-019-05653-7

M3 - Review article

C2 - 31143998

AN - SCOPUS:85068802557

SN - 0342-4642

VL - 45

SP - 977

EP - 987

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - 7

ER -

Changes in critically ill cancer patients’ short-term outcome over the last decades: results of systematic review with meta-analysis on individual data

Abstract

Keywords

UN SDGs

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