Characteristics and Outcome of Cancer Patients Admitted to the ICU in England, Wales, and Northern Ireland and National Trends Between 1997 and 2013*

Ostermann, Marlies; Ferrando-Vivas, Paloma; Gore, Carmen; Power, Sarah; Harrison, David A

doi:10.1097/ccm.0000000000002589

Cited by 80 publications

(82 citation statements)

References 43 publications

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“…The hospital mortality of our study population was similar to other European literature (44%) (3)(4)(5)(24)(25)(26)(27). In contrast, the long-term mortality in our study was higher than in other studies (28)(29)(30)(31)(32)(33)(34).…”

Section: Discussionsupporting

confidence: 86%

“…Over the past two decades, the number of patients with a malignancy requiring intensive care treatment has increased (1). Historically, during the 1980's and 1990's, patients with a malignancy were commonly considered ineligible for intensive care treatment due to their presumed unfavourable outcome (2,3).…”

mentioning

confidence: 99%

“…Moreover, the ICU and hospital mortality of patients with an active malignancy has decreased signi cantly (1,3,5). Patients with a solid malignancy show a similar mortality rate compared to critically ill patients admitted to the ICU without a malignancy (6).…”

mentioning

confidence: 99%

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Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

Zee¹,

Noordhuis²,

Epker³

et al. 2020

Preprint

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Background Intensive Care Unit (ICU) triage decisions in patients with a malignancy can be difficult as clinicians have concerns about potential unfavourable outcomes. Therefore, clinicians may have doubts about the appropriateness of an ICU admission. The aim of this study was to assess the long-term mortality and performance status of critically ill patients with an active malignancy or a malignancy in their prior history admitted unplanned to the ICU. Furthermore, we aimed to compare the long-term mortality of those patients to the mortality of patients without a malignancy. Methods We conducted a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned admission to the ICU in 2017 in two groups: 1) the study population consisting of patients with an active malignancy and patients with a malignancy in their medical history (complete remission, CR) and 2) patients without a malignancy. Pearson’s Chi-square tests and Independent Samples T-Tests or the Mann-Whitney U tests were used to evaluate the long-term mortality, the primary objective was 2-year mortality. Results Of the 1046 unplanned ICU admissions, 125 (12%) patients had an active malignancy, 41 (3.9%) < 5 year CR and 33 (3.2%) ≥ 5 year CR. The 2-year mortality in the study population was significantly higher than in the population without a malignancy (67.4% and 40.2%, P < 0.001). The median performance status at 2 years after ICU admission in the study population was 1 (IQR 0–2). SOFA score (OR 1.25; 95% CI 1.10–1.42) and ECOG performance status of 2 (OR 11.23; 95% CI 2.66–47.33), 3 (OR 5.91; 95% CI 1.77–19.79) and 4 (OR 13.16; 1.85–93.74) were independently associated with 2-year mortality. Conclusions Two thirds of the study population died within 2 years after ICU admission, which is higher than in the population without a malignancy. However, the majority of the study population had a good performance status at 2 years after ICU admission. The severity of the critical illness and the performance status before ICU admission are independently associated with 2-year mortality and should be considered as main factors in ICU triage.

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

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Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

Zee¹,

Noordhuis²,

Epker³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In the current study, about two‐thirds of patients involved in the reported errors exhibited low health literacy, communication difficulties or isolation. This finding reflects the general characteristics of patients in ICUs (Ostermann et al, ; Smith et al, ). Further, these patients, compared with other patients, are unstable, require more complicated nursing care and cannot protect themselves (Beccaria et al, ; Garrouste‐Orgeas et al, ; Wittich et al, ).…”

Section: Discussionsupporting

confidence: 59%

Nature of nursing errors and their contributing factors in intensive care units

Eltaybani

Mohamed

Abdelwareth

2018

Nursing in Critical Care

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“…A systematic review of published outcomes for patients with solid tumours admitted to ICU described an average ICU mortality of 40.1% for patients with lung cancer, the highest of all the individual tumour types described [3]. However, lung cancer is one of the commonest tumour types admitted to ICU [2,6,7].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with intensive care admission in patients with lung cancer: a population-based observational study of 26, 731 patients

et al. 2020

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Background: Lung cancer is the most common cause of cancer related death worldwide and survival is poor. Patients with lung cancer may develop a critical illness, but it is unclear what features are associated with an Intensive Care Unit (ICU) admission. Methods: This retrospective, observational, population-based study of linked cancer registration, ICU, hospital discharge and mortality data described the factors associated with ICU admission in patients with lung cancer. The cohort comprised all incident cases of adult lung cancer diagnosed between 1st January 2000 and 31st December 2009 in the West of Scotland, UK, who were subsequently admitted to an ICU within 2 years of cancer diagnosis. Multiple logistic regression was used to determine factors associated with admission. Results: 26,731 incident cases of lung cancer were diagnosed with 398 (1.5%) patients admitted to an ICU. Patients were most commonly admitted with respiratory conditions and there was a high rate of invasive mechanical ventilation. ICU, in-hospital and six-month survival were 58.5, 42.0 and 31.2%, respectively. Surgical treatment of lung cancer increased the odds of ICU admission (OR 7.23 (5.14-10.2)). Odds of admission to ICU were reduced with older age (75-80 years OR 0.69 (0.49-0.94), > 80 years OR 0.21 (0.12-0.37)), female gender (OR 0.73 (0.59-0.90)) and radiotherapy (OR 0.54 (0.39-0.73)) or chemotherapy treatment (OR 0.52 (0.38-0.70)). Conclusion: 1.5% of patients diagnosed with lung cancer are admitted to an ICU but both short term and long term survival was poor. Factors associated with ICU admission included age < 75 years, male gender and surgical treatment of cancer

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Characteristics and Outcome of Cancer Patients Admitted to the ICU in England, Wales, and Northern Ireland and National Trends Between 1997 and 2013*

Cited by 80 publications

References 43 publications

Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

Nature of nursing errors and their contributing factors in intensive care units

Factors associated with intensive care admission in patients with lung cancer: a population-based observational study of 26, 731 patients

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