RESUMO
Objective To evaluate the incidence and to investigate risk factors of supraventricular arrhythmia (SVAs) in postoperative cancer patients in intensive care unit ( ICU ). Methods Data of 570 patients consecutively admitted to oncologic surgical ICU of Cancer Hospital of Chinese Academy of Medical Sciences from Nov. 2008 to Oct. 2009 were retrospectively collected. Univariate and multivariate logistic analysis were conducted for potential factors that influenced SAVs. Results Thirteen patients with a history of atrial fibrillation (AF) were excluded and 557 patients were eligible for the study. SVAs occurred in 72 patients ( 12. 93% ). Multivariate analysis showed four independent predictors of SVAs including age ( OR = 1. 066,95%CI: 1. 034 - 1. 099,P ＜0. 001 ) ,a history of coronary heart diseases ( OR = 2. 644,95% CI: 1. 459 - 4. 790,P ＜ 0. 05), sepsis ( OR = 2. 374,95% CI: 1. 098 - 5. 135, P ＜ 0. 05 ) and intra-thoracic procedure ( OR =2. 322,95 % CI: 1.061 - 5.084, P ＜ 0. 05 ) . ICU length of stay, severity ( APACHE Ⅱ scores in SVAs patients) were significantly greater in patients who were not affected by SVAs ( ICU stay: [2 ( 1 ～ 77 )]vs [3 ( 1 ～ 40 )]days,P ＜ 0. 001; APACHE Ⅱ score: [9 (0 ～ 37 )] vs [11 (3 ～ 38 )], P = 0. 001 ). Nine cases died in SVAs patients ( 12. 5% ) and 19 died in the non-SVAs patients (3.9%), with significant difference between the two groups( x2 = 9. 673, P = 0. 002). Conclusion In oncologic surgical ICU, the incidence of SVAs is high. Age,history of coronary heart diseases, sepsis and intra-thoracic procedure were independent rsik factors of SVAs. SVAs prolong ICU length of stay. SVAs is a marker of critical illness severity.
RESUMO
Objective To investigate the factors influencing the outcomes of patients with ALI/ARDS.Method Data of 63 patients with ALI/ARDS in ICU,Cancer Hospital,Chinese Academy of Medical Science,from January 2005 to December 2006,were retrospectively analyzed.Patients were divided into survivor group(n=39)and non-survivor group(n=24)according to different outcomes,and equally,patients were classified in the rcspect of different causes as pulmonary origin and extra-pulmonary origin.Results The incidence of ALI/ARDS was 5.2%(63/1201)in ICU.The univariate analysis showed that the differences in the length of mechanical ventilation(P=0.028),blood creatinine level(P=0.031),oxygenation index(P=0.023),between survivor group and non-survivor group.In addition,the differences in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores and sequential organ failure assessment(SOFA)on the admission day were significant between survival group and non-survival group(P<0.001,respectively).Logistic regression analysis showed that APACHE Ⅱ scores was the only independent predictor of the mortality in patients with ALI/ARDS(P=0.015,OR:3.809,95%CI:1.295～11.203).There was no significant difference in one-year survival between pul-monary origin cause of ALI/ARDS group and exwa-pulmonary origin cause of ALI/ARDS group(63.9% vs.55.4%).There was significant difference in one-year survival between ARDS and ALI group(44.9% vs.88.9%,P<0.05).Conclusions APACHE Ⅱscores on the admission day of patients is the only independent predictor of the mortality in patients with ALI/ARDS,whereas the underlying cause of ALI/ARDS does not matter to the survival of patients.