Description

Fu et al identified factors associated with poor survival after a first admission to the intensive care unit (ICU) for a patient with advanced cancer referred for a Phase I clinical trial These can help to identify patients who should be made do-not-resuscitate (DNR). The authors are from the University of Texas M.D. Anderson Cancer Center in Houston.


 

Patient selection: advanced cancer referred to a Phase I clinical trials program. Entry into a Phase I clinical trial requires advanced cancer that is refractory to standard therapy or for which there is no effective standard therapy that will increase survival for >= 3 months.

 

Predictors of a poor overall survival after the ICU admission:

(1) NOT (following a surgical intervention)

(2) hypoalbuminemia

(3) higher APACHE II score on ICU admission (>= 18)

(4) need for cardiopulmonary resuscitation (CPR) and/or mechanical ventilation

 

Although long-term survival is rare for this group of patients, these risk factors can help to identify a group for whom survival is short.

 


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