Renal Replacement Therapy in Patients With Stage IV Cancer Admitted to the Intensive Care Unit With Acute Kidney Injury at a Comprehensive Cancer Center Was Not Associated With Survival
| Autor: | Bo Zhao, Chan Shen, Ibrahim Dahbour, Maen Abdelrahim, Joanna Grace M. Manzano, Jaya Sheela Amaram-Davila, Valda D. Page, Alvin H. Moss, Juhee Song, Ala Abudayyeh, Sriram Yennu, Marina George, Shouhao Zhou, Sreedhar Mandayam, Rima N. Pai, Joseph L. Nates |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Hospitalized patients Organ Dysfunction Scores medicine.medical_treatment 030204 cardiovascular system & hematology Cancer Care Facilities urologic and male genital diseases Article law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Neoplasms medicine Humans In patient 030212 general & internal medicine Renal replacement therapy Hospital Mortality Aged Neoplasm Staging Retrospective Studies business.industry Acute kidney injury Cancer General Medicine Acute Kidney Injury Middle Aged medicine.disease Advanced cancer Intensive care unit Survival Analysis female genital diseases and pregnancy complications Renal Replacement Therapy Intensive Care Units Logistic Models Female Stage iv business |
| Zdroj: | Am J Hosp Palliat Care |
| Popis: | Introduction: In patients with advanced cancer, prolongation of life with treatment often incurs substantial emotional and financial expense. Among hospitalized patients with cancer since acute kidney injury (AKI) is known to be associated with much higher odds for hospital mortality, we investigated whether renal replacement therapy (RRT) use in the intensive care unit (ICU) was a significant independent predictor of worse outcomes. Methods: We retrospectively reviewed patients admitted in 2005 to 2014 who were diagnosed with stage IV solid tumors, had AKI, and a nephrology consult. The main outcomes were survival times from the landmark time points, inpatient mortality, and longer term survival after hospital discharge. Logistic regression and Cox proportional regression were used to compare inpatient mortality and longer term survival between RRT and non-RRT groups. Propensity score-matched landmark survival analyses were performed with 2 landmark time points chosen at day 2 and at day 7 from ICU admission. Results: Of the 465 patients with stage IV cancer admitted to the ICU with AKI, 176 needed RRT. In the multivariate logistic regression model after adjusting for baseline serum albumin and baseline maximum Sequential Organ Failure Assessment (SOFA), the patients who received RRT were not significantly different from non-RRT patients in inpatient mortality (odds ratio: 1.004 [95% confidence interval: 0.598-1.684], P = .9892). In total, 189 patients were evaluated for the impact of RRT on long-term survival and concluded that RRT was not significantly associated with long-term survival after discharge for patients who discharged alive. Landmark analyses at day 2 and day 7 confirmed the same findings. Conclusions: Our study found that receiving RRT in the ICU was not significantly associated with inpatient mortality, survival times from the landmark time points, and long-term survival after discharge for patients with stage IV cancer with AKI. |
| Databáze: | OpenAIRE |
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