to analyze the scoring systems and test rating about chemotherapy for cancer patients supported by critical care medicine, hope to provide some clinical basis for the choice of chemotherapy for severe tumors.

We retrospectively analyzed the clinical data of 44 patients admitted to ICU and then given chemotherapy in ICU at the Sun Yat-sen University from January 2010 to December 2016. All patients were diagnosed as malignant tumors. According to the change of the patient′s condition after chemotherapy, they were divided into the worsening group (24) and the improvement group (20). The initial oncology scoring systems [Karnofsky (KPS), Eastern Cooperative Oncology Group (ECOG)] and intensive medical scoring systems [Acute Physiology and Chronic Health Evaluation 2 (APACHEⅡ), sequential organ failure assessment (SOFA), Logistic organ dysfunoction system (LODS), quick sequential organ failure assessment (qSOFA), multiple organ dysfunction score (MODS), systematic inflammatory response syndrome (SIRS) and National early warning score (NEWS)] were calculated with the relevant indexs; results of different scoring systems, the test results before chemotherapy, the symptoms during chemotherapy and supportive methods during chemotherapy were analyzed using SPSS 22.0 statistical software.

There was no significant difference between various scoring systems. The proportion of using vasoactive drugs to increase blood pressure, ALT, ALP and GGT in provement group were higher than these in worsening group. The differences were statistically significant (P<0.05). The proportion of using vasoactive drugs to increase blood pressure, ALT, ALP, GGT were included in multivariate analysis. It was found that ″using vasoactive drugs to increase blood pressure″ (OR=12.306, 95%CI: 1.200-126.175) and ALP (OR=1.020, 95%CI: 1.003-1.039) were independent risk factors for predicting the prognosis of critically ill cancer patients. The area under the curve (AUC) of ALP was 0.753, 95%CI: 0.605-0.901 with 86.25 of cut-off value, 83.3% of sensitivity, and 70.0% of specificity.

In ICU, general scoring system or severe medical scoring system are unable to predict whether severe patients are resistant to chemotherapy or would benef from chemotherapy. The prognosis of patients with hematologic malignancies is better than that of solid tumors. The liver function index of patients can be useful to predict the resistance to chemotherapy patients, ″using vasoactive drugs to increase blood pressure″ and ALP are the independent risk factors for prognosis after chemotherapy.

Intensive care medicine; Cancer; Critically ill patients; Chemotherapy