Post-intensive care unit syndrome in gynecologic oncology patients

Camille C. Gunderson, Adam C. Walter, Rachel Ruskin, Kai Ding, Kathleen N. Moore

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: The purposes of the present study are to describe the demographic and treatment characteristics of women on the gynecologic oncology service who required intensive care and assess prevalence of risk factors for post-intensive care syndrome (PICS). Methods: A retrospective chart review was performed encompassing patients requiring admission to the intensive care unit (ICU) on the gynecology oncology service between 1/2008 and 12/2012. Descriptive statistics were computed using SAS version 9.3. Results: One hundred eleven patients met study criteria. Most were Caucasian (85 %), were married (50 %), and had stage III/IV disease (82 %). Risk factors for PICS were as follows: 9 % had baseline anxiety, 20 % had baseline depression, 21 % were taking an SSRI prior to admission, and 18 % took other psychiatric medications. Most ICU admissions (47 %) were for planned post-operative management. Thirty-seven percent required mechanical ventilation for a median of 1 day (range, 1–24). Twenty percent required new scheduled psychiatric medications while in the ICU, and 8.1 % of patients were discharged with a newly prescribed antidepressant. Of patients, 15.3 % had consultations with psychiatry or social work. Six percent of patients expired, and 18 % had a nontraditional discharge disposition. Overall, 60 % of the patients had at least one recognized risk factor for PICS. Conclusions: Given the preponderance of psychiatric disorders and mechanical ventilation during post-operative ICU care in patients with gynecologic cancer, prospective evaluation of risk factors and utility of risk-reducing interventions for PICS is warranted. Long-term cognitive or physical disability is known to hasten mortality; thus, preventative strategies may increase the survival and quality of life for this patient population.

Original languageEnglish (US)
Pages (from-to)4627-4632
Number of pages6
JournalSupportive Care in Cancer
Volume24
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Fingerprint

Intensive Care Units
Critical Care
Psychiatry
Artificial Respiration
Patient Admission
Social Work
Gynecology
Antidepressive Agents
Patient Care
Referral and Consultation
Anxiety
Quality of Life
Demography
Depression
Survival
Mortality
Population
Neoplasms

Keywords

  • Gynecologic oncology
  • Intensive care unit
  • PICS
  • Post-intensive care syndrome
  • Psychiatric

ASJC Scopus subject areas

  • Oncology

Cite this

Post-intensive care unit syndrome in gynecologic oncology patients. / Gunderson, Camille C.; Walter, Adam C.; Ruskin, Rachel; Ding, Kai; Moore, Kathleen N.

In: Supportive Care in Cancer, Vol. 24, No. 11, 01.11.2016, p. 4627-4632.

Research output: Contribution to journalArticle

Gunderson, Camille C. ; Walter, Adam C. ; Ruskin, Rachel ; Ding, Kai ; Moore, Kathleen N. / Post-intensive care unit syndrome in gynecologic oncology patients. In: Supportive Care in Cancer. 2016 ; Vol. 24, No. 11. pp. 4627-4632.
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abstract = "Purpose: The purposes of the present study are to describe the demographic and treatment characteristics of women on the gynecologic oncology service who required intensive care and assess prevalence of risk factors for post-intensive care syndrome (PICS). Methods: A retrospective chart review was performed encompassing patients requiring admission to the intensive care unit (ICU) on the gynecology oncology service between 1/2008 and 12/2012. Descriptive statistics were computed using SAS version 9.3. Results: One hundred eleven patients met study criteria. Most were Caucasian (85 {\%}), were married (50 {\%}), and had stage III/IV disease (82 {\%}). Risk factors for PICS were as follows: 9 {\%} had baseline anxiety, 20 {\%} had baseline depression, 21 {\%} were taking an SSRI prior to admission, and 18 {\%} took other psychiatric medications. Most ICU admissions (47 {\%}) were for planned post-operative management. Thirty-seven percent required mechanical ventilation for a median of 1 day (range, 1–24). Twenty percent required new scheduled psychiatric medications while in the ICU, and 8.1 {\%} of patients were discharged with a newly prescribed antidepressant. Of patients, 15.3 {\%} had consultations with psychiatry or social work. Six percent of patients expired, and 18 {\%} had a nontraditional discharge disposition. Overall, 60 {\%} of the patients had at least one recognized risk factor for PICS. Conclusions: Given the preponderance of psychiatric disorders and mechanical ventilation during post-operative ICU care in patients with gynecologic cancer, prospective evaluation of risk factors and utility of risk-reducing interventions for PICS is warranted. Long-term cognitive or physical disability is known to hasten mortality; thus, preventative strategies may increase the survival and quality of life for this patient population.",
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