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Annals of Intensive Care

Table 1 Characteristics of the study population according to the cancer status

From: Clinical spectrum and prognostic impact of cancer in critically ill patients with HIV: a multicentre cohort study

 

All patients (n = 939)

Patients without active cancer (n = 736)

Patients with active ADC (n = 106)

Patients with active NADC (n = 97)

P-value

Male sex

670 (71.3)

514 (69.8)

79 (74.5)

77 (79.4)

0.11

Age, years

52 (43–59)

52 (43–59)

50 (42–57)

55 (47–62)

0.02

Precaritya

136 (14.5)

104 (14.1)

16 (15.1)

16 (16.5)

0.81

WHO performance status

 0

514 (54.7)

454 (61.7)

41 (38.7)

19 (19.6)

 < 0.0001

 1–2

334 (35.6)

224 (30.4)

49 (46.2)

61 (62.9)

 

 3–4

91 (9.7)

58 (7.9)

16 (15.1)

17 (17.5)

 

HIV-related characteristics

 Newly diagnosed HIV infectionb

127 (13.5)

105 (14.3)

18 (17.0)

4 (4.1)

0.01

  CD4 cell count at admission, per µL

51 (20–147)

50 (20–150)

57 (38–94)

360 (340–380)

 < 0.0001

 Previously known HIV infection

812 (86.5)

631 (85.7)

88 (83.0)

93 (95.9)

0.01

  cART at admission

699 (74.4)

539 (73.2)

72 (67.9)

88 (90.7)

 < 0.0001

  Baseline CD4 cell count, per µLc

370 (180–600)

436 (230–682)

221 (95–484)

301 (170–470)

 < 0.0001

 History of AIDS-defining OId

301 (32.1)

231 (31.4)

37 (34.9)

33 (34.0)

0.96

 History of HIV encephalitisd

21 (2.2)

16 (2.2)

5 (4.7)

0

0.07

 History of Castleman diseased

16 (1.7)

12 (1.6)

1 (0.9)

0

0.40

 History of ADC (remission or cured)d

  Any

50 (5.3)

41 (5.6)

0

9 (9.3)

0.01

  AIDS-defining NHL

11 (1.2)

9 (1.2)

0

2 (2.1)

0.38

  Kaposi sarcoma

39 (4.2)

31 (4.2)

0

8 (8.2)

0.01

  Cervix cancer

1 (0.1)

1 (0.1)

0

0

NA

History of NADC (remission or cured)d

 Any

53 (5.6)

51 (6.9)

2 (1.9)

0

0.004

 Solid NADC

41 (5.5)

39 (5.3)

2 (1.9)

0

0.02

 Haematological NADC

13 (1.4)

13 (1.8)

0

0

0.16

Chronic conditions

 Respiratory

199 (21.2)

172 (23.4)

7 (6.6)

20 (20.6)

0.0004

  COPD

107 (11.4)

88 (12.0)

2 (1.9)

17 (17.5)

0.001

 Cardiac

175 (18.6)

149 (20.2)

12 (11.3)

14 (14.4)

0.05

  Coronary heart disease

92 (9.8)

80 (10.9)

3 (2.8)

9 (9.3)

0.03

 Renal

171 (18.2)

153 (20.8)

6 (5.7)

12 (12.4)

0.0002

 Hepatic

200 (21.3)

168 (22.8)

10 (17.9)

22 (22.7)

0.008

  Chronic HBV infection

72 (7.7)

56 (7.6)

6 (5.7)

10 (10.3)

0.46

  Chronic HCV infection

111 (11.8)

93 (12.6)

5 (4.7)

13 (13.4)

0.06

  Liver cirrhosis

74 (7.9)

58 (7.9)

4 (3.8)

12 (12.4)

0.08

 Neurological

105 (11.2)

90 (12.2)

3 (2.8)

12 (12.4)

0.01

 Psychiatric

114 (12.1)

101 (13.7)

8 (7.5)

5 (5.2)

0.02

Solid organ transplantation

24 (2.6)

24 (3.3)

0

0

0.03

Mode of ICU admission

 Direct from the emergency department

603 (64.2)

525 (71.3)

33 (31.1)

45 (46.4)

 < 0.0001

 Transfer from wards

336 (35.8)

211 (28.7)

73 (68.9)

52 (53.6)

 

  Time from hospital admission, days

7 (3–18)

6 (3–17)

9 (4–18)

9 (3–17)

 < 0.0001

SAPS 2 at ICU admission

36 (26–51)

34 (23–47)

51 (39–63)

41 (30–56)

 < 0.0001

SOFA score at ICU admission

4 (2–6)

4 (2–6)

4 (2–8)

4 (2–7)

0.06

Type of ICU admission

 Medical

904 (96.3)

710 (96.5)

105 (99.1)

89 (91.8)

0.009

 Unscheduled surgery

13 (1.4)

12 (1.6)

0

1 (1.0)

 

 Scheduled surgery

22 (2.3)

14 (1.9)

1 (0.9)

7 (7.2)

 

Main reason for ICU admission

 Acute respiratory failure

320 (34.1)

262 (35.6)

27 (25.5)

31 (32.0)

 < 0.0001

 Sepsis/septic shock

172 (18.3)

127 (17.3)

23 (21.7)

22 (22.7)

 

 Comae

165 (17.6)

139 (18.9)

14 (13.2)

12 (12.4)

 

 Acute kidney failure

56 (6.0)

43 (5.8)

8 (7.5)

5 (5.2)

 

 Drug overdose

47 (5.0)

46 (6.3)

0

1 (1.0)

 

 Metabolic

47 (5.0)

17 (2.3)

21 (19.8)

9 (9.3)

 

 Shock (other than septic)

28 (3.0)

24 (3.3)

1 (0.9)

3 (3.1)

 

 Cardiac arrest

16 (1.7)

14 (1.9)

0

2 (2.1)

 

 Others

88 (9.3)

64 (8.7)

12 (11.3)

12 (12.4)

 

Neutropenia at ICU admission

46 (4.9)

18 (2.4)

19 (17.9)

9 (9.3)

 < 0.0001

Main diagnosis of the ICU stay

 Cancer-related non-infectious complication

116 (12.4)

–

69 (65.1)

47 (48.5)

NA

  NADC

47 (5.0)

–

–

47 (48.5)

NA

  ADC

69 (7.7)

–

69 (65.1)

–

NA

   Tumor lysis syndrome

27 (3.1)

–

27 (25.5)

–

NA

Non-infectious complication of chronic conditionf

242 (25.8)

232 (31.5)

1 (0.9)

9 (9.3)

 < 0.0001

  Respiratory

46 (4.9)

44 (6.0)

0

2 (2.1)

 < 0.0001

  Cardiac

41 (4.4)

39 (5.3)

1 (0.9)

1 (1.0)

 

  Renal

28 (3.0)

28 (3.8)

0

0

 

  Hepatic

12 (1.3)

9 (1.2)

0

3 (3.1)

 

  Neurological

24 (2.6)

23 (3.1)

0

1 (1.0)

 

  Psychiatric/addiction

65 (6.9)

63 (8.6)

0

2 (2.1)

 

  Others

26 (2.8)

26 (3.5)

0

0

 

 Bacterial sepsisg

263 (28.0)

206 (28.0)

25 (23.6)

32 (33.0)

0.33

 Non-AIDS-defining non-bacterial infectionh

43 (4.6)

42 (5.7)

1 (0.9)

0

0.007

 AIDS-defining OI

156 (16.6)

147 (20.0)

7 (6.6)

2 (2.1)

 < 0.0001

  Pneumocystis jirovecii pneumonia

69 (7.3)

66 (9.0)

3 (2.8)

0

0.001

  Cerebral toxoplasmosis

30 (3.2)

28 (3.8)

2 (1.9)

0

0.1

  Tuberculosis

14 (1.5)

12 (1.6)

1 (0.9)

1 (1.0)

0.79

  Other OI

43 (4.6)

41 (5.6)

1 (0.9)

1 (1.0)

0.02

 cART-related toxicity

7 (0.7)

7 (1.0)

0

0

0.38

 Miscellaneous

111 (11.9)

102 (13.9)

3 (2.8)

9 (9.3)

0.003

Organ support in the ICU

 High-flow nasal oxygen therapy

96 (10.2)

73 (9.9)

9 (8.5)

14 (14.4)

0.32

 Non-invasive ventilation

73 (7.8)

63 (8.6)

2 (1.9)

8 (8.2)

0.06

 Invasive mechanical ventilation

301 (32.1)

228 (31.0)

37 (34.9)

36 (37.1)

0.38

 Vasopressors

242 (25.8)

169 (23.0)

42 (39.6)

31 (32.0)

0.0004

 Renal replacement therapy for AKI

105 (11.2)

73 (9.9)

24 (22.6)

8 (8.2)

0.0002

 VA-ECMO

4 (0.4)

4 (0.5)

0

0

0.57

 VV-ECMO

10 (1.1)

9 (1.2)

0

1 (1.0)

0.52

Chemotherapy in the ICU

71 (7.6)

8 (1.1) i

50 (47.2)

13 (13.4)

 < 0.0001

TLD during the ICU stay

110 (11.7)

59 (8.0)

19 (17.9)

32 (33.0)

 < 0.0001

  Organ support withdrawal

38 (4.0)

22 (3.0)

4 (3.8)

12 (12.4)

 < 0.0001

  Organ support withholding

72 (7.7)

37 (5.0)

15 (14.2)

20 (20.6)

 < 0.0001

Outcomes

 ICU length of stay, days

5 (3–9)

4 (3–9)

6 (3–11)

5 (3–9)

0.03

 Hospital length of stay, days

19 (10–36)

17 (9–33)

33 (17–60)

22 (11–36)

 < 0.0001

 ICU readmission in ICU survivors

48/827 (5.8)

36/667 (5.4)

10/87 (11.5)

2/73 (2.7)

0.04

 In-ICU death

112 (11.9)

69 (9.4)

19 (17.9)

24 (24.7)

 < 0.0001

 In-hospital death, overall

167 (17.8)

91 (12.4)

32 (30.2)

44 (45.4)

 < 0.0001

  Post-ICU death, overall

55 (5.9)

22 (3.0)

13 (12.3)

20 (20.6)

 < 0.0001

  Post-ICU death related to cancer

24 (2.6)

–

8 (7.5)

16 (16.5)

NA

  1. Data are exposed as number (percentage) or median (interquartile range)
  2. ADC, AIDS-defining cancer; NADC, non-AIDS-defining cancer; WHO, World Health Organization; cART, combination antiretroviral therapy; AIDS, acquired immune deficiency syndrome; OI, opportunistic infection; PML, progressive multifocal leukoencephalopathy; ADC, AIDS-defining cancer; NHL, non-Hodgkin lymphoma; COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; SAPS 2, simplified acute physiology score 2; SOFA, sepsis-related organ failure assessment; ICU, intensive care unit; AKI, acute kidney injury; VA/VV-ECMO, veno-arterial/veno-venous extracorporeal membrane oxygenation; TLD, treatment limitation decision
  3. aHomeless (n = 29), migrants (n = 54), incarcerated patient (n = 1) and other complex social situations (n = 52);
  4. bDiagnosis of HIV infection during the same hospital stay (inaugural admission);
  5. cWithin 6 months prior to ICU admission;
  6. dNot active at ICU admission (remission or cured for neoplasms);
  7. eExcluding patients with drug overdose;
  8. fNon-neoplastic chronic conditions;
  9. gSee Additional file 1: Table S2 for details;
  10. hMalaria (n = 20), COVID-19 (n = 7), influenza (n = 7), others (n = 9);
  11. iChemotherapy for Castleman disease (n = 2) and/or haemophagocytic lymphohistiocytosis (n = 6)
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