Evaluation of the association between mortality and KDIGO classification and inflammation based prognostic scores in oncology patients hospitalized in intensive care unit

Intraduction: Cancer patients are at risk of life-threatening disease requiring intensive care unit (ICU) admission. ICU admission indications for cancer patients can be due to disease itself, treatment related complications or comorbid disease. Acute kidney injury (AKI) and infections are the leading causes of mortality in these patients. So, we aim to assess the relationship between mortality in cancer patients and KDIGO (Kidney Disease Improving Global Outcomes) which is the latest classification of AKI and inflammation based prognostic scores. Materials and methods: 386 patients with oncologic malignancies which were hospitalized in Internal Medicine Intensive Care Unit and Medical Oncology Intensive Care Unit of Dicle University Faculty of Medicine Research and Application Hospital between 2010 and 2014 years were included in the study. Demographic characteristics, etiologies, comorbid conditions and laboratory findings of patients were obtained from the patient files. Length of stay in the intensive care unit and outcomes were recorded., Patients were classified according to presence or absence of AKI, KDIGO staging (stage 1, 2, 3), RDW (>16.8 or ≤ 16.8), neutrophil/lymphocyte ratio (NLR) (≤5 or >5), platelet/lymphocyte ratio (PLR) (<150, 150-300, ≥300), modified Glasgow Prognostic Scoring (m GPS) system and death (group 1: dead, group 2: alive) Results: Patient population in group 1 and group 2 were 276 and 110 respectively. There was more female patient in group 1 than group 2. Creatinine, crp, neutrophil and rdw values were statistically significantly higher in group 1 than group 2 (p<0.005). Albumin, hemoglobin, platelet, lymphocyte and the length of stay in intensive care unit were statistically significantly lower in group 1 than group 2 (p<0.005). There were positive relationship between mortality and KDIGO stages, RDW and NLR. KDIGO stage 1, stage 2 and stage 3 increased mortality 1.9, 2.3 and 2.4 times respectively. Also, NLR >5 and RDW>16.8 increased mortality 1.5 and 1.4 times respectively. There was no statistically significant relationship between mortality and m GPS and PLR. Conclusion: KDIGO stages, RDW>16.8 and NLR>5 were found independent prognostic factors for oncologic patients hospitalized in intensive care unit. In this patient group; there was also shorter duration of stay in the intensive care unit