Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
Identifieur interne : 001262 ( Pmc/Checkpoint ); précédent : 001261; suivant : 001263Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies
Auteurs : Marianne R. F. Bosscher [Pays-Bas] ; Esther Bastiaannet [Pays-Bas] ; Barbara L. Van Leeuwen [Pays-Bas] ; Harald J. Hoekstra [Pays-Bas]Source :
- Annals of Surgical Oncology [ 1068-9265 ] ; 2015.
Abstract
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.
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.
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 (
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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DOI: 10.1245/s10434-015-4939-8
PubMed: 26553441
PubMed Central: 4858551
Affiliations:
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies</title>
<author><name sortKey="Bosscher, Marianne R F" sort="Bosscher, Marianne R F" uniqKey="Bosscher M" first="Marianne R. F." last="Bosscher">Marianne R. F. Bosscher</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea>
<placeName><settlement type="city">Groningue</settlement>
<region nuts="2" type="province">Groningue (province)</region>
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<author><name sortKey="Bastiaannet, Esther" sort="Bastiaannet, Esther" uniqKey="Bastiaannet E" first="Esther" last="Bastiaannet">Esther Bastiaannet</name>
<affiliation wicri:level="3"><nlm:aff id="Aff2">Department of Surgery, Leiden University Medical Center, Leiden University, Leiden, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Surgery, Leiden University Medical Center, Leiden University, Leiden</wicri:regionArea>
<placeName><settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
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<affiliation wicri:level="3"><nlm:aff id="Aff3">Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden University, Leiden, The Netherlands</nlm:aff>
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<wicri:regionArea>Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden University, Leiden</wicri:regionArea>
<placeName><settlement type="city">Leyde</settlement>
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<author><name sortKey="Van Leeuwen, Barbara L" sort="Van Leeuwen, Barbara L" uniqKey="Van Leeuwen B" first="Barbara L." last="Van Leeuwen">Barbara L. Van Leeuwen</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea>
<placeName><settlement type="city">Groningue</settlement>
<region nuts="2" type="province">Groningue (province)</region>
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<author><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name>
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<wicri:regionArea>Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea>
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<series><title level="j">Annals of Surgical Oncology</title>
<idno type="ISSN">1068-9265</idno>
<idno type="eISSN">1534-4681</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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 (<italic>p</italic>
= 0.006), Eastern Cooperative Oncology Group performance score (ECOG-PS) >0 (<italic>p</italic>
for trend: <italic>p</italic>
= 0.03), and raised lactate dehydrogenase (LDH) (<italic>p</italic>
< 0.001). Additional factors associated with 90-day mortality were low handgrip strength (HGS) (<italic>p</italic>
= 0.01) and low albumin (<italic>p</italic>
= 0.002).</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Surg Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann. Surg. Oncol</journal-id>
<journal-title-group><journal-title>Annals of Surgical Oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1068-9265</issn>
<issn pub-type="epub">1534-4681</issn>
<publisher><publisher-name>Springer International Publishing</publisher-name>
<publisher-loc>Cham</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26553441</article-id>
<article-id pub-id-type="pmc">4858551</article-id>
<article-id pub-id-type="publisher-id">4939</article-id>
<article-id pub-id-type="doi">10.1245/s10434-015-4939-8</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Healthcare Policy and Outcomes</subject>
</subj-group>
</article-categories>
<title-group><article-title>Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bosscher</surname>
<given-names>Marianne R. F.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bastiaannet</surname>
<given-names>Esther</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Leeuwen</surname>
<given-names>Barbara L.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Hoekstra</surname>
<given-names>Harald J.</given-names>
</name>
<degrees>MD, PhD</degrees>
<address><phone>+31-50-3612317</phone>
<email>h.j.hoekstra@umcg.nl</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<aff id="Aff1"><label></label>
Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</aff>
<aff id="Aff2"><label></label>
Department of Surgery, Leiden University Medical Center, Leiden University, Leiden, The Netherlands</aff>
<aff id="Aff3"><label></label>
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden University, Leiden, The Netherlands</aff>
</contrib-group>
<pub-date pub-type="epub"><day>9</day>
<month>11</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>9</day>
<month>11</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><year>2016</year>
</pub-date>
<volume>23</volume>
<fpage>1803</fpage>
<lpage>1814</lpage>
<history><date date-type="received"><day>10</day>
<month>3</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2015</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), 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.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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 (<italic>p</italic>
= 0.006), Eastern Cooperative Oncology Group performance score (ECOG-PS) >0 (<italic>p</italic>
for trend: <italic>p</italic>
= 0.03), and raised lactate dehydrogenase (LDH) (<italic>p</italic>
< 0.001). Additional factors associated with 90-day mortality were low handgrip strength (HGS) (<italic>p</italic>
= 0.01) and low albumin (<italic>p</italic>
= 0.002).</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</abstract>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Society of Surgical Oncology 2016</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Pays-Bas</li>
</country>
<region><li>Groningue (province)</li>
<li>Hollande-Méridionale</li>
</region>
<settlement><li>Groningue</li>
<li>Leyde</li>
</settlement>
</list>
<tree><country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Bosscher, Marianne R F" sort="Bosscher, Marianne R F" uniqKey="Bosscher M" first="Marianne R. F." last="Bosscher">Marianne R. F. Bosscher</name>
</region>
<name sortKey="Bastiaannet, Esther" sort="Bastiaannet, Esther" uniqKey="Bastiaannet E" first="Esther" last="Bastiaannet">Esther Bastiaannet</name>
<name sortKey="Bastiaannet, Esther" sort="Bastiaannet, Esther" uniqKey="Bastiaannet E" first="Esther" last="Bastiaannet">Esther Bastiaannet</name>
<name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name>
<name sortKey="Van Leeuwen, Barbara L" sort="Van Leeuwen, Barbara L" uniqKey="Van Leeuwen B" first="Barbara L." last="Van Leeuwen">Barbara L. Van Leeuwen</name>
</country>
</tree>
</affiliations>
</record>
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