Clinico-demographic and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study

Abstract

A bstract Objectives Critically ill solid organ malignancy patients admitted to intensive care unit (ICU) as unplanned medical admissions behave differently from other subsets of cancer patients (hematolymphoid malignancies and cancer patients admitted for postoperative care). These patients if appropriately selected may benefit from the ICU care. There is paucity of data on critically ill unplanned admissions of solid organ malignancies from South Asia. We analyzed data of patients with solid tumors with unplanned admissions to the ICU to determine the clinical, epidemiological characteristics, and predictors of hospital mortality in an Indian ICU. Materials and methods This prospective, observational study was done in our 14-bedded mixed medical–surgical ICU from July 2014 to November 2015. We included all consecutive adult unplanned admissions with solid organ malignancies having ICU stay of >24 hours. Surgical admissions, hematolymphoid malignancies, advanced malignancy with no treatment options, and those cured of cancer >5 years were excluded. Results Two hundred and thirty-five consecutive patients were included in this cohort. ICU and hospital mortalities were 36.6 and 40%, respectively. On multivariate analysis, cancer status [odds ratio (OR): 3.204; 95% confidence interval (CI): 1.271–8.078], invasive mechanical ventilation (OR: 5.940; 95% CI: 2.632–13.408), and sequential organ failure assessment (SOFA) score on the day of ICU admission (OR: 1.199; 95% CI: 1.042–1.379) were independent predictors of hospital mortality. Conclusion Acute respiratory failure and septic shock are the common reasons of unplanned ICU admission for patients with solid organ malignancies. With good patient selection, more than half of such patients are likely to be discharged alive from the hospital. How to cite this article Siddiqui SS, Narkhede AM, Chaudhari HK, Ravisankar NP, Dhundi U, Sarode S, et al. Clinico-demographic and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study. Indian J Crit Care Med 2021;25(12):1421–1426.

A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs

“…The characteristics of the 46 included studies are described in eTable 1 (http://links.lww.com/CCX/B54). Most of the published literature was from Europe ( n = 18) (15–32), followed by Asia ( n = 12) (33–44), North America ( n = 9) (4, 45–52), South America ( n = 5) (5, 53–56), and Oceania ( n = 2) (57, 58). On the other hand, studies from North America contributed the highest number of patients ( n = 37,255), followed by South America ( n = 32,723), Asia ( n = 23,540), Europe ( n = 16,149), and Oceania ( n = 478).…”

“…Thirty-seven studies reported data on length of stay in the ICU (4, 5, 16–19, 21, 23–25, 28, 29, 32–36, 38–52, 54–58). The WM length of stay was 5.9 days (95% CI, 5.3–6.5 d), and the median was 5.7 days (range, 2.7–23.7 d).…”

Complicaciones neurológicas como motivo de ingreso en una Unidad de Cuidados Intensivos Oncológicos

“…Estudios publicados recientemente, refieren que la frecuencia de ingresos en la UCI por motivos neurológicos en pacientes con cáncer varía entre el 3% y el 23% [2], [3], [4], [5], [6].…”