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Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies

BACKGROUND: The clinical outcome of patients with oncologic emergencies is often poor and mortality is high. It is important to determine which patients may benefit from invasive treatment, and for whom conservative treatment and/or palliative care would be appropriate. In this study, prognostic fac...

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Autores principales: Bosscher, Marianne R. F., Bastiaannet, Esther, van Leeuwen, Barbara L., Hoekstra, Harald J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858551/
https://www.ncbi.nlm.nih.gov/pubmed/26553441
http://dx.doi.org/10.1245/s10434-015-4939-8
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author Bosscher, Marianne R. F.
Bastiaannet, Esther
van Leeuwen, Barbara L.
Hoekstra, Harald J.
author_facet Bosscher, Marianne R. F.
Bastiaannet, Esther
van Leeuwen, Barbara L.
Hoekstra, Harald J.
author_sort Bosscher, Marianne R. F.
collection PubMed
description BACKGROUND: The clinical outcome of patients with oncologic emergencies is often poor and mortality is high. It is important to determine which patients may benefit from invasive treatment, and for whom conservative treatment and/or palliative care would be appropriate. In this study, prognostic factors for clinical outcome are identified in order to facilitate the decision-making process for patients with surgical oncologic emergencies. METHODS: This was a prospective registration study for patients over 18 years of age, who were consulted for surgical oncologic emergencies between November 2013 and April 2014. Multiple variables were registered upon emergency consultation, and the follow-up period was 90 days. Multivariate logistic regression analysis was performed to identify factors associated with 30- and 90-day mortality. RESULTS: During the study period, 207 patients experienced surgical oncologic emergencies—101 (48.8 %) men and 106 (51.2 %) women, with a median age of 64 years (range 19–92). The 30-day mortality was 12.6 % and 90-day mortality was 21.7 %. Factors significantly associated with 30-day mortality were palliative intent of cancer treatment prior to emergency consultation (p = 0.006), Eastern Cooperative Oncology Group performance score (ECOG-PS) >0 (p for trend: p = 0.03), and raised lactate dehydrogenase (LDH) (p < 0.001). Additional factors associated with 90-day mortality were low handgrip strength (HGS) (p = 0.01) and low albumin (p = 0.002). CONCLUSIONS: Defining the intent of prior cancer treatment and the ECOG-PS are of prognostic value when deciding on treatment for patients with surgical oncologic emergencies. Additional measurements of HGS, LDH, and albumin levels can serve as objective parameters to support the clinical assessment of individual prognosis.
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spelling pubmed-48585512016-05-21 Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies Bosscher, Marianne R. F. Bastiaannet, Esther van Leeuwen, Barbara L. Hoekstra, Harald J. Ann Surg Oncol Healthcare Policy and Outcomes BACKGROUND: The clinical outcome of patients with oncologic emergencies is often poor and mortality is high. It is important to determine which patients may benefit from invasive treatment, and for whom conservative treatment and/or palliative care would be appropriate. In this study, prognostic factors for clinical outcome are identified in order to facilitate the decision-making process for patients with surgical oncologic emergencies. METHODS: This was a prospective registration study for patients over 18 years of age, who were consulted for surgical oncologic emergencies between November 2013 and April 2014. Multiple variables were registered upon emergency consultation, and the follow-up period was 90 days. Multivariate logistic regression analysis was performed to identify factors associated with 30- and 90-day mortality. RESULTS: During the study period, 207 patients experienced surgical oncologic emergencies—101 (48.8 %) men and 106 (51.2 %) women, with a median age of 64 years (range 19–92). The 30-day mortality was 12.6 % and 90-day mortality was 21.7 %. Factors significantly associated with 30-day mortality were palliative intent of cancer treatment prior to emergency consultation (p = 0.006), Eastern Cooperative Oncology Group performance score (ECOG-PS) >0 (p for trend: p = 0.03), and raised lactate dehydrogenase (LDH) (p < 0.001). Additional factors associated with 90-day mortality were low handgrip strength (HGS) (p = 0.01) and low albumin (p = 0.002). CONCLUSIONS: Defining the intent of prior cancer treatment and the ECOG-PS are of prognostic value when deciding on treatment for patients with surgical oncologic emergencies. Additional measurements of HGS, LDH, and albumin levels can serve as objective parameters to support the clinical assessment of individual prognosis. Springer International Publishing 2015-11-09 2016 /pmc/articles/PMC4858551/ /pubmed/26553441 http://dx.doi.org/10.1245/s10434-015-4939-8 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Healthcare Policy and Outcomes
Bosscher, Marianne R. F.
Bastiaannet, Esther
van Leeuwen, Barbara L.
Hoekstra, Harald J.
Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
title Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
title_full Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
title_fullStr Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
title_full_unstemmed Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
title_short Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
title_sort factors associated with short-term mortality after surgical oncologic emergencies
topic Healthcare Policy and Outcomes
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858551/
https://www.ncbi.nlm.nih.gov/pubmed/26553441
http://dx.doi.org/10.1245/s10434-015-4939-8
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