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| Effect of early intervention on prognosis of ICU patients with severe tumor |
| Chen Xue-jiao, Cang Shun-dong, Bai Bing, Zhao Wei-feng, Wen Yi-yang, Hu Jin-long, Fu Lei |
| Department of Oncology, Medical Reproduction Center of Zhengzhou University People′s Hospital, Henan Provincial People′s Hospital, Zhengzhou 450003, China |
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Abstract Objective To evaluate the effect of early interventionon the prognosis of patients with severe tumor in the general wards during hospitalization and eventually transferred to ICU. Methods The medical emergency team (MET) was established in the oncology department of our hospital. MET startup standards were draught up. Early intervention for patients with severe tumor with physiological disturbances and eventually admitted to ICU. The patients were divided into survival group and death group according to whether the patient died in hospital; and divided into pre-intervention group and post-intervention group according to different timing of patient intervention. The effect of early intervention and early intervention time on the prognosis of each group was compared. Cox proportional hazards model was used to evaluate the independent factors affecting the prognosis of patients. Results A total of 449 patients with severe tumor were treated with MET and transferred from general ward to ICU. 145 (32.3%) patients died during their stay in ICU. The intervention time (t=21.095, P＜0.001) of the death group was significantly higher than that of the survival group［(2.98±0.82) h vs. (1.32±0.47)h, t=21.095, P＜0.001］. The ICU mortality［18.0% (34/189) vs. 42.3%(110/260), χ2 =29.709, P＜0.001］, hospital mortality［39.7%(75/189) vs. 67.7%(176/260), χ2=34.831, P＜0.001］, 30-day mortality［29.1% (55/189) vs. 55.0%(143/260), χ2=29.780, P＜0.001］,and 1 year cumulative mortality (log-rank test, P=0.029) in the pre-intervention group were significantly lower than those in the post-intervention group. Cox proportional hazard model analysis showed that the intervention time(HR=1.027, 95% CI 1.017～1.037, P＜0.001) was positively correlated with the 1 year mortality rate. Early intervention(HR=0.456, 95% CI 0.348～0.597, P＜0.001) and early intervention in earlier stage(HR=0.485, 95% CI 0.372～0.633, P＜0.001) were negatively correlated with 1 year mortality rate. Conclusion Early intervention can significantly improve the short-term and long-term prognosis of patients with severe tumor in the general ward. Therefore, early identification and timely treatment are of great significance.
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Corresponding Authors:
Cang Shun-dong, E-mail:2928532882@qq.com
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