Mortality prediction in cancer patients in intensive care. A single center study: Original Research

Abstract

Introduction:  The mortality of cancer patients admitted to an intensive care unit can be estimated using sepsis scales. The objective of the present study was to carry out a diagnostic test between the main scales in a group of cancer patients from a reference center in Guayaquil-Ecuador.

Methodology: A cross-sectional study was carried out in the intensive care unit of the "Dr. Juan Tanca Marengo" National Oncology Institute of SOLCA-Guayaquil, from October 2019 to November 2020. The sample was probabilistic of patients with a clinical oncological diagnosis admitted to the ICU. Age, type of cancer, family history, mortality, and the SOFA and APACHE II scales were recorded. Descriptive statistics are used, and a diagnostic test and a survival analysis are performed.

Results: 99 cases were analyzed, 57 ± 16 years old and 37 men (37.4%). Arterial hypertension (39.4%) and type 2 diabetes mellitus (17.1%). 12.1% cases of non-Hodgkin's lymphoma and intestinal cancer 11.1%; 17 deaths (17.2%). The overall SOFA score was 6.8 ± 3.0, and the global APACHE II score of 18.6 ± 7.0. The risk of mortality was statistically significant from the fifth day. The SOFA score >6 had a sensitivity of 88.24%, the positive predictive value (VP) was shallow, and the specificity; the negative PV was 97%. The APACHE II scale had a sensitivity of 94.12%, with a specificity of 96.34%; Positive PV, compared to the SOFA scale, was double.

Conclusion: The APACHE II scale in clinical cancer patients admitted to the ICU predicts mortality more accurately when the score exceeds 18.