scholarly journals P2.14-009 Assessing the Value of Radiotherapy for Lung Cancer in the Intensive Care Unit – A Population-based analysis

2017 ◽  
Vol 12 (11) ◽  
pp. S2178
Author(s):  
A. Louie ◽  
L. Li ◽  
K. Bray Jenkyn ◽  
B. Allen ◽  
A. Warner ◽  
...  
2017 ◽  
Vol 99 (2) ◽  
pp. S85-S86
Author(s):  
A.V. Louie ◽  
L. Li ◽  
K. Jenkyn ◽  
B. Allen ◽  
G. Rodrigues ◽  
...  

2018 ◽  
Vol 10 (3) ◽  
pp. 1440-1448 ◽  
Author(s):  
Alexander V. Louie ◽  
Lihua Li ◽  
Krista Bray Jenkyn ◽  
Britney Allen ◽  
George B. Rodrigues ◽  
...  

2017 ◽  
Vol 35 (2) ◽  
pp. 236-242 ◽  
Author(s):  
Alisha Kassam ◽  
Rinku Sutradhar ◽  
Kimberley Widger ◽  
Adam Rapoport ◽  
Jason D. Pole ◽  
...  

Purpose Children with cancer often receive high-intensity (HI) medical care at the end-of-life (EOL). Previous studies have been limited to single centers or lacked detailed clinical data. We determined predictors of and trends in HI-EOL care by linking population-based clinical and health-services databases. Methods A retrospective decedent cohort of patients with childhood cancer who died between 2000 and 2012 in Ontario, Canada, was assembled using a provincial cancer registry and linked to population-based health-care data. Based on previous studies, the primary composite measure of HI-EOL care comprised any of the following: intravenous chemotherapy < 14 days from death; more than one emergency department visit; and more than one hospitalization or intensive care unit admission < 30 days from death. Secondary measures included those same individual measures and measures of the most invasive (MI) EOL care (eg, mechanical ventilation < 14 days from death). We determined predictors of outcomes with appropriate regression models. Sensitivity analysis was restricted to cases of cancer-related mortality, excluding treatment-related mortality (TRM) cases. Results The study included 815 patients; of these, 331 (40.6%) experienced HI-EOL care. Those with hematologic malignancies were at highest risk (odds ratio, 2.5; 95% CI, 1.8 to 3.6; P < .001). Patients with hematologic cancers and those who died after 2004 were more likely to experience the MI-EOL care (eg, intensive care unit, mechanical ventilation, odds ratios from 2.0 to 5.1). Excluding cases of TRM did not substantively change the results. Conclusion Ontario children with cancer continue to experience HI-EOL care. Patients with hematologic malignancies are at highest risk even when excluding TRM. Of concern, rates of the MI-EOL care have increased over time despite increased palliative care access. Linking health services and clinical data allows monitoring of population trends in EOL care and identifies high-risk populations for future interventions.


Lung Cancer ◽  
2005 ◽  
Vol 49 ◽  
pp. S159
Author(s):  
J. Maniate ◽  
S. Sharma ◽  
S. Navaratnam

2002 ◽  
Vol 30 (11) ◽  
pp. 2462-2467 ◽  
Author(s):  
Kevin B. Laupland ◽  
David A. Zygun ◽  
H. Dele Davies ◽  
Deirdre L. Church ◽  
Thomas J. Louie ◽  
...  

2014 ◽  
Vol 45 (2) ◽  
pp. 491-500 ◽  
Author(s):  
Anne-Claire Toffart ◽  
Carola Alegria Pizarro ◽  
Carole Schwebel ◽  
Linda Sakhri ◽  
Clemence Minet ◽  
...  

The decision-making process for the intensity of care delivered to patients with lung cancer and organ failure is poorly understood, and does not always involve intensivists. Our objective was to describe the potential suitability for intensive care unit (ICU) referral of lung cancer in-patients with organ failures.We prospectively included consecutive lung cancer patients with failure of at least one organ admitted to the teaching hospital in Grenoble, France, between December 2010 and October 2012.Of 140 patients, 121 (86%) were evaluated by an oncologist and 49 (35%) were referred for ICU admission, with subsequent admission for 36 (73%) out of those 49. Factors independently associated with ICU referral were performance status ⩽2 (OR 10.07, 95% CI 3.85–26.32), nonprogressive malignancy (OR 7.00, 95% CI 2.24–21.80), and no explicit refusal of ICU admission by the patient and/or family (OR 7.95, 95% CI 2.39–26.37). Factors independently associated with ICU admission were the initial ward being other than the lung cancer unit (OR 6.02, 95% CI 1.11–32.80) and an available medical ICU bed (OR 8.19, 95% CI 1.48–45.35).Only one-third of lung cancer patients with organ failures were referred for ICU admission. The decision not to consider ICU admission was often taken by a non-intensivist, with advice from an oncologist rather than an intensivist.


2017 ◽  
Vol 61 (4) ◽  
pp. 408-417 ◽  
Author(s):  
G. M. Jonsdottir ◽  
S. H. Lund ◽  
B. Snorradottir ◽  
S. Karason ◽  
I. H. Olafsson ◽  
...  

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