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Korean J Crit Care Med > Volume 24(3); 2009 > Article
Korean Journal of Critical Care Medicine 2009;24(3): 140-144. doi: https://doi.org/10.4266/kjccm.2009.24.3.140
항암화학요법을 받은 고형암 환자들의 중증 의료관련폐렴의 임상상
*부산대학교 의과대학 양산부산대학교병원 응급의학과, 성균관대학교 의과대학 삼성서울병원 내과학교실 †호흡기내과, ‡혈액종양내과
Severe Health-care Associated Pneumonia among the Solid Cancer Patients on Chemotherapy
Maeng Real Park, So Young Park, Kyeongman Jeon, Won Jung Koh, Man Pyo Chung, Hojoong Kim, O Jung Kwon, Gee Young Suh, Jin Seok Ahn, Myung Ju Ahn, Ho Yeong Lim
1Department of Emergency Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
2Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. suhgy@skku.edu
3Division of Hematology and Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
BACKGROUND: There are only inadequate studies on the characteristics of severe pneumonia in the patients who have solid cancer and who are treated with cytotoxic chemotherapy and also on the usefulness of the various severity index scores. METHODS: We retrospectively reviewed 31 patients who were treated with cytotoxic chemotherapy because of solid cancer and who were admitted to the medical ICU at Samsung Medical Center from April 2007 to August 2008. RESULTS: The median age of the 31 patients was 64 years old (34-79). The types of solid cancer were lung cancer (19, 61.3%), gastroesophageal cancer (4, 12.9%), breast cancer (2, 6.5%), liver cancer (1, 3.2%), ovarian cancer (1, 3.2%) and other types of cancer (4, 12.9%). The hospital mortality rate was 64.5%. We were able to determine the pathogen of 19 (61.3%) patients; S. pneumoniae (6), S. aureus (3), Candida species (3), P. aeruginosa (2), K. pneumoniae (1), Pneumocystis jiroveci (1) and others (3). There were no statistically differences of the laboratory data and severity index scores (PSI, CURB-65, APACHE II, SOFA, SAPS 3) between the survivors and nonsurvivors, except the P/F ratio. CONCLUSIONS: The hospital mortality rate of severe pneumonia in patients who had solid cancer and who received cytotoxic chemotherapy was high. The major pathogen was S. pneumoniae. The severity indexes for general pneumonia were not useful to these patients.
Key Words: adjuvant chemotherapy; immunocompromised host; mortality; pathogens; pneumonia; severity of illness index
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