Outcomes of cancer patients after unplanned admission to general intensive care units

Bos, Monique M.E.M.; Keizer, Nicolette F. de; Meynaar, Iwan A.; Bakhshi‐Raiez, Ferishta; Jonge, Evert de

doi:10.3109/0284186x.2012.679311

Cited by 79 publications

(73 citation statements)

References 25 publications

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“…Patients with certain malignant diseases, such as esophageal cancer or acute leukemia, and those undergoing allogeneic stem cell transplantation have particularly high ICU utilization rates of up to almost 30% . Currently, patients with malignancies account for approximately 13.5% to 21.5% of all ICU admissions . In the past, patients with cancer, especially those with solid tumors, were frequently denied access to the ICU .…”

Section: Evolution Of Critical Care For Patients With Cancermentioning

confidence: 99%

Critical care of patients with cancer

Shimabukuro‐Vornhagen

Böll

Kochanek

et al. 2016

CA A Cancer J Clinicians

112

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Answer questions and earn CME/CNE The increasing prevalence of patients living with cancer in conjunction with the rapid progress in cancer therapy will lead to a growing number of patients with cancer who will require intensive care treatment. Fortunately, the development of more effective oncologic therapies, advances in critical care, and improvements in patient selection have led to an increased survival of critically ill patients with cancer. As a consequence, critical care has become an important cornerstone in the continuum of modern cancer care. Although, in many aspects, critical care for patients with cancer does not differ from intensive care for other seriously ill patients, there are several challenging issues that are unique to this patient population and require special knowledge and skills. The optimal management of critically ill patients with cancer necessitates expertise in oncology, critical care, and palliative medicine. Cancer specialists therefore have to be familiar with key principles of intensive care for critically ill patients with cancer. This review provides an overview of the state-of-the-art in the individualized management of critically ill patients with cancer. CA Cancer J Clin 2016. © 2016 American Cancer Society.

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Section: Evolution Of Critical Care For Patients With Cancermentioning

confidence: 99%

Critical care of patients with cancer

Shimabukuro‐Vornhagen

Böll

Kochanek

et al. 2016

CA A Cancer J Clinicians

112

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“…Previous investigations reported on the incidence of cancer and its impact on the outcome in general ICUs . These studies showed that a cancer diagnosis on admission to a general ICU is relatively common, varying between 13.5% and 21.5%, and that the outcome of these patients is strongly dependent on the type of admission, with planned surgical and unplanned medical admission types bearing the relatively best and worst prognosis, respectively .…”

Section: Introductionmentioning

confidence: 99%

Intensive care admission of cancer patients: a comparative analysis

et al. 2015

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The aim of this study was to obtain insight into which proportion of cancer patients is admitted to an Intensive Care Unit (ICU) and how their survival, demographic, and clinical characteristics relate to cancer patients not admitted to the ICU. Data from patients registered with cancer between 2006 and 2011 in four hospitals in the Netherlands were linked to the Dutch National Intensive Care Evaluation registry. About 36,860 patients with cancer were identified, of whom 2,374 (6.4%) were admitted to the ICU. Fifty-six percent of ICU admissions were after surgery, whereas 44% were for medical reasons. The risk for ICU admission was highest among cancer patients treated with surgery either alone or combined with chemotherapy and/or radiation therapy. Only 80 of 1,073 medical ICU admissions (3.3%) were for cancer-specific reasons. Although more women (54.0%) than men were registered with cancer, the proportion of male cancer patients admitted to an ICU was much higher (9.3 vs. 4.0%, P < 0.001). Five-year survival of cancer patients admitted to the ICU was substantial (41%) although median survival was much lower (1,104 days) than in patients not admitted to the ICU (median survival time not reached, P < 0.001). These results show that one out of 16 cancer patients was admitted to an ICU and that ICU support for this group should not be considered futile.

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“…Direct comparisons with other similar studies are difficult, with significant potential variation in intensive care admission criteria and patient population. Nevertheless, the ICU mortality in our cohort was 5%, which was consistent, if not better than seen in recent studies of similar Australian tertiary hospital ICUs, as well as internationally . Mortality at 6 months of 39% similarly compared favourably.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of oncology unit patients requiring admission to an Australian intensive care unit

Tan

Jacques

Oatley

et al. 2019

Internal Medicine Journal

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Background Patients with advanced malignancies have historically been considered poor candidates for admission to the intensive care unit (ICU); however, prognosis is continually improving, and requirements for ICU access are increasing. Aim To understand the characteristics and outcomes of oncology unit patients admitted to an Australian ICU and identify potential prognostic factors. Methods A single‐centre, retrospective, cohort study conducted at a tertiary public hospital with a quaternary ICU in Sydney, Australia. All patients admitted under the medical oncology team requiring ICU admission between June 2014 and June 2016 were evaluated. Clinical outcomes were determined including mortality, ICU requirements (ventilation, dialysis, vasopressors, infection) and prognostic scores (Acute Physiologic and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) score). Results There were 96 patients with mean age 61 years, 58% were male and 76% had metastatic disease. Most were receiving palliative treatment (89%), with recent chemotherapy (43%), immunotherapy (10%) and other therapies (5%). Of the 10 patients with recent immunotherapy, three (all with melanoma) required ICU admission due to immunotoxicity; 13% were admitted due to an oncological emergency. Mean APACHE II score was 17 (standard deviation (SD) 5.33), mean SOFA score was 3.99 (SD 2.70), ICU mortality was 5% and hospital mortality was 22%. Using multivariate logistic regression analysis, cancer stage, infection during ICU admission, intracranial mass effect on ICU admission and SOFA score were associated with 30‐day mortality. Conclusion Our patient population had good short‐term survival outcomes despite most receiving palliative treatment. Cancer patients can achieve positive outcomes after ICU admission, and appropriate selection of patients is crucial.

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Outcomes of cancer patients after unplanned admission to general intensive care units

Cited by 79 publications

References 25 publications

Critical care of patients with cancer

Critical care of patients with cancer

Intensive care admission of cancer patients: a comparative analysis

Characteristics and outcomes of oncology unit patients requiring admission to an Australian intensive care unit

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