Abstract
Background: Despite cancer being the second most common cause of death in the United States, more people are living longer after the diagnosis of cancer than before. Healthcare workers will be treating an increasing number of patients with cancer. Various studies have identified predictors of cardiac arrest in the general population, however, none have been done to identify such factors in cancer patients who form a more vulnerable group with lower survival rate following cardiac arrest.Methods: We retrospectively analysed charts of all patients with active cancer who experienced in-hospital cardiac arrest (IHCA) and underwent cardio-pulmonary resuscitation (CPR) from January 2015 to December 2017 at our hospital (n=44, group A). We compared this group to 44 consecutive patients with active cancer admitted to the oncology unit who did not experience cardiac arrest (n=44, group B). We excluded patients in remission.Results: Both the groups were comparable in terms of age (69 ± 14 vs 68 ± 15, p=0.776) and gender distribution (50% vs 56% males, p=0.521). Prevalence of coronary artery disease (CAD) (25% vs 11%, p=0.097), hypertension (68% vs 66%, p=0.821), hyperlipidaemia (34% in both groups, p=1.000), tobacco abuse (18% vs 27%, p=0.308), and diabetes mellitus (34% vs 23%, p=0.237) was not significantly different between the two groups. Group with cardiac arrest had significantly higher alanine aminotransferase (100 U/L ± 150 vs 47 U/L ± 87, p=0.043), alkaline phosphatase (288 U/L ± 512 vs 118 U/L ± 80, p=0.032), creatinine (1.8 mg/dl ± 1.74 vs 1.1 mg/dl ± 0.76, p=0.023), international normalised ratio (INR) (2.1 ± 1.5 vs 1.2 ± 0.5, p=0.005), and lower estimated -glomerular filtration rate (43 mL/min/1.73m2 ± 17 vs 51 mL/min/1.73m2 ± 15, p=0.022) on admission. Group A also had significantly higher incidence of sepsis during the hospital course as compared to group B (30% vs 2%, p<0.001). In group A, 11.4% survived to discharge as compared to 95.5% in group B. Significantly higher number of patients in group B were taking chemotherapy (77.27% vs 34.09%, p=0.000046) and radiation therapy (65.9% vs 22.72%, p=0.000046) as compared to group A.Conclusion: Cancer patients who experienced IHCA had worse renal and hepatic function; they were frequently diagnosed with sepsis and had similar cardiovascular risk factors as compared to cancer patients who did not experience cardiac arrest. Furthermore, a higher number of patients with active cancer who did not experience cardiac arrest were on chemotherapy, immunotherapy or radiation therapy.
Highlights
According to the Centers for Disease Control and Prevention (CDC), cancer was the second leading cause of death in 2015 with 595,930 deaths preceded only by heart disease as the number one cause of death [1]
Among 209 patients with in-hospital cardiac arrest (IHCA) followed by cardiopulmonary resuscitation from January 2015 to December 2017, 44 patients had active cancer (21.05%)
There was no significant difference in the prevalence of coronary artery disease (CAD), hyperlipidaemia, hypertension, diabetes mellitus, tobacco abuse, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF) between the two groups
Summary
According to the Centers for Disease Control and Prevention (CDC), cancer was the second leading cause of death in 2015 with 595,930 deaths preceded only by heart disease as the number one cause of death [1]. In spite of cancer being the second leading cause of death, people diagnosed with cancer in the United States are living longer than before [2]. Healthcare providers will be expected to treat an increasing number of cancer patients in their practice; they should be able to identify patients with high risk of mortality. Several scoring systems have been developed to identify patients on regular medical floors at high risk for adverse events. Multiple studies have validated their use in real-time [5] These scoring systems predict the probability of an adverse event in the general. Despite cancer being the second most common cause of death in the United States, more people are living longer after the diagnosis of cancer than before. Various studies have identified predictors of cardiac arrest in the general population, none have been done to identify such factors in cancer patients who form a more vulnerable group with lower survival rate following cardiac arrest
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call