Dados do Resumo

Título

Admission Mobilization Level and Its association with Mortality in Oncological patients in the Intensive Care Unit

Introdução

The admission of oncology patients to Intensive Care Units (ICUs) is a complex issue. Adverse effects of hospitalization are common, such as muscle weakness acquired in the ICU, and its rehabilitation results from various intrinsic and extrinsic factors. When admitting a patient, assessing mobility through tools can guide treatment and predict mortality, thereby informing personalized decisions for managing the care team’s actions.

Objetivo

Examine the association between early mobilization and mortality in oncology patients in the ICU.

Métodos

Retrospective study through the analysis of medical records of patients who have been in the ICU at ACCamargo Cancer Center. Included were oncology patients without remission criteria, with either planned or unplanned ICU admissions. Two groups were composed: planned admissions (surgical) and unplanned admissions (non-surgical or clinical).
Sociodemographic variables were analyzed. The level of mobilization at ICU admission was assessed using two scales: the Eastern Cooperative Oncology Group (ECOG) Performance Status and the Intensive Care Unit Mobility Scale (IMS). Mortality levels were evaluated using the Acute Physiology and Chronic Health Evaluation (APACHE II).

Resultados

The study included 100 patients, divided between the groups, with n=50 in each. The sample was composed of 57% female subjects. The planned admission group had an average age of 45.4 ± 11.8 years, with colorectal cancer diagnoses being the most common (n=11), while the unplanned admission group had an average age of 43.2 ± 10.2 years, and 11 of them had hematological cancer diagnoses.
The ECOG (planned: β -1.6 and p = 0.0; unplanned: β -3.0 and p = 0.0) and APACHE II (planned: β -9.6 and p = 0.0; unplanned: β -2.3 and p = 0.0) showed a significant association with mortality in the ICU or hospital. The IMS did not show a significant correlation with mortality (planned: β 1.6 and p = 0.4; unplanned: β 3.0 and p = 0.3). It was observed that in the unplanned admission group, the need for Non-Invasive Mechanical Ventilation (NIVM) (β -0.2 and p = 0.0) had a significant association with ICU or hospital mortality.

Conclusões

A comprehensive assessment of functional status and disease severity in hospitalized oncology patients is essential at ICU admission. In this study, the ECOG and APACHE II scales proved valuable tools for risk stratification and outcome prediction, offering an opportunity to optimize therapy. In the unplanned admission patient group, the use of NIMV was positively associated with mortality, making it important to consider its indication on an individual basis.

Palavras Chave

Oncology Intensive Care Unit; Admission mobilization; mortality