The Appropriateness of Invasive Ventilation in COVID-19 Positive Cancer Patients: Proposal of a New Prognostic Score
Abstract
1. Introduction
2. Invasive Ventilation in Cancer Patients
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
- Taccone, F.S.; Artigas, A.A.; Sprung, C.L.; Moreno, R.; Sakr, Y.; Vincent, J.L. Characteristics and outcomes of cancer patients in European ICUs. Crit. Care 2009, 13, R15. [Google Scholar] [CrossRef] [PubMed]
- Lecuyer, L.; Chevret, S.; Thiery, G.; Darmon, M.; Schlemmer, B.; Azoulay, É. The ICU Trial: A new admission policy for cancer patients requiring mechanical ventilation. Crit. Care Med. 2007, 35, 808–814. [Google Scholar] [CrossRef] [PubMed]
- Schellongowski, P.; Sperr, W.R.; Wohlfarth, P.; Knoebl, P.; Rabitsch, W.; Watzke, H.H.; Staudinger, T. Critically ill patients with cancer: Chances and limitations of intensive care medicine—A narrative review. ESMO Open 2016, 1, e000018. [Google Scholar] [CrossRef] [PubMed]
- Huaringa, A.J.; Francis, W.H. Outcome of invasive mechanical ventilation in cancer patients: Intubate or not to intubate a patient with cancer. J. Crit. Care 2019, 50, 87–91. [Google Scholar] [CrossRef] [PubMed]
- Ferreira, F.L. Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients. JAMA 2001, 286, 1754. [Google Scholar] [CrossRef] [PubMed]
- Meng, L.; Qiu, H.; Wan, L.; Ai, Y.; Xue, Z.; Guo, Q.; Deshpande, R.; Zhang, L.; Meng, J.; Tong, C.; et al. Intubation and Ventilation amid the COVID-19 Outbreak. Anesthesiology 2020, 132, 1317–1332. [Google Scholar] [CrossRef] [PubMed]
- Liang, W.; Guan, W.; Chen, R.; Wang, W.; Li, J.; Xu, K.; Li, C.; Ai, Q.; Lu, W.; Liang, H.; et al. Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China. Lancet Oncol. 2020, 21, 335–337. [Google Scholar] [CrossRef]
- Zhou, F.; Yu, T.; Du, R.; Fan, G.; Liu, Y.; Liu, Z.; Xiang, J.; Wang, Y.; Song, B.; Gu, X.; et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020, 395, 1054–1062. [Google Scholar] [CrossRef]
- Statista. From COVID-19/Coronavirus, Facts and Figures. Available online: https://www.statista.com/page/covid-19-coronavirus (accessed on 19 April 2020).
- Soto-Perez-de-Celis, E.; Li, D.; Yuan, Y.; Lau, Y.M.; Hurria, A. Functional versus chronological age: Geriatric assessments to guide decision making in older patients with cancer. Lancet Oncol. 2018, 19, e305–e316. [Google Scholar] [CrossRef]
- Zhang, J.; Wang, X.; Jia, X.; Li, J.; Hu, K.; Chen, G.; Wei, J.; Gong, Z.; Zhou, C.; Yu, H.; et al. Risk factors for disease severity, unimprovement, and mortality of COVID-19 patients in Wuhan, China. Clin. Microbiol. Infect. 2020, 26, 767–772. [Google Scholar] [CrossRef] [PubMed]
- Phua, J.; Weng, L.; Ling, L.; Egi, M.; Lim, C.M.; Divatia, J.V.; Shrestha, B.R.; Arabi, Y.M.; Ng, J.; Gomersall, C.D.; et al. Intensive care management of coronavirus disease 2019 (COVID-19): Challenges and recommendations. Lancet Respir. Med. 2020, 8, 506–517. [Google Scholar] [CrossRef]
- COVID-19 More Frequent, Severe in Cancer Patients. Cancer Discov. 2020, 10, OF1. [CrossRef] [PubMed]
- COVID-19 Prolonged in Patients with Cancer. Cancer Discov. 2021. [CrossRef]
Variables | SOFA Score | ||||
---|---|---|---|---|---|
0 | 1 | 2 | 3 | 4 | |
Respiratory PaO2/FIO2 (P/F) mmHg | >400 | ≤400 | ≤300 | ≤200 * | ≤100 * |
Coagulation Platelets x 109/μg | >150 | ≤150 | ≤100 | ≤50 | ≤20 |
Liver Bilirubin mg/dL | <1.2 | 1.2–1.9 | 2.0–5.9 | 6.0–11.9 | >12 |
Cardiovascular Hypotension | No hypotension | Mean arterial pressure < 70 mmHg | Dopamine ≤ 5 or dobutamine (any dose) | Dopamine > 5, epinephrine ≤ 0.1, or norepinephrine ≤ 0.1 | Dopamine > 15, epinephrine > 0.1 or norepinephrine > 0.1 |
Central nervous system Glasgow Coma Score Scale | 15 | 13–14 | 10–12 | 6–9 | <6 |
Renal Creatinine mg/dL | <1.2 | 1–2–1.9 | 2.0–3.4 | 3.5–4.9 | >5 |
Variables | Score | Categories of risk for patients Score < 4: Low Risk ICU admission and invasive ventilation. Score 4–6: Intermediate Risk Case-by-case evaluation for appropriateness of ICU admission and invasive ventilation. Score ≥ 7: High Risk Palliative treatment. |
Patient characteristics Sex Age BMI Comorbidities | F = 0 M = 1 < 70 = 0 ≥ 70 = 1 < 30 = 0 ≥ 30 = 1 NO = 0 YES = 1 YES > 1 = 2 | |
Oncological variables Treatment intent Life expectancy Patient on treatment | Curative = 0 Palliative = 1 > 6 mo = 0 < 6 mo = 1 NO = 0 YES = 1 | |
Clinical parameters + laboratory values SOFA SCORE D-dimer | 2–7 = 0 ≥ 8 = 1 < 1 μg/mL= 0 >1 μg/mL = 1 |
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Ghidini, M.; Indini, A.; Rijavec, E.; Bareggi, C.; Cattaneo, M.; Tomasello, G.; Galassi, B.; Gambini, D.; Grossi, F. The Appropriateness of Invasive Ventilation in COVID-19 Positive Cancer Patients: Proposal of a New Prognostic Score. Viruses 2021, 13, 508. https://doi.org/10.3390/v13030508
Ghidini M, Indini A, Rijavec E, Bareggi C, Cattaneo M, Tomasello G, Galassi B, Gambini D, Grossi F. The Appropriateness of Invasive Ventilation in COVID-19 Positive Cancer Patients: Proposal of a New Prognostic Score. Viruses. 2021; 13(3):508. https://doi.org/10.3390/v13030508
Chicago/Turabian StyleGhidini, Michele, Alice Indini, Erika Rijavec, Claudia Bareggi, Monica Cattaneo, Gianluca Tomasello, Barbara Galassi, Donatella Gambini, and Francesco Grossi. 2021. "The Appropriateness of Invasive Ventilation in COVID-19 Positive Cancer Patients: Proposal of a New Prognostic Score" Viruses 13, no. 3: 508. https://doi.org/10.3390/v13030508
APA StyleGhidini, M., Indini, A., Rijavec, E., Bareggi, C., Cattaneo, M., Tomasello, G., Galassi, B., Gambini, D., & Grossi, F. (2021). The Appropriateness of Invasive Ventilation in COVID-19 Positive Cancer Patients: Proposal of a New Prognostic Score. Viruses, 13(3), 508. https://doi.org/10.3390/v13030508