Characteristics and Outcomes of cancer patients admitted to ICU
CCCF ePoster library. Al Saied G. Oct 2, 2017; 198167; 33
Dr. Ghiath Al Saied
Dr. Ghiath Al Saied
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Characteristics and Outcomes of cancer patients admitted to ICU

Al Saied, Ghiath1; AlMaani, Mohammed1; Alhawdar, Taher1; Alzahrani, Saud1; Abdullah Almotairi1

1. Section of Critical Care Medicine, King Fahad Medical City, Riyadh, Saudi Arabia

Cancer is one of the leading causes of morbidity and mortality worldwide. Some will require unplanned ICU care. The characteristics and outcomes of these patients are sometimes not well defined to treating ICU physicians, leading to inconsistent prognostication and therapeutic decisions. Some of these patients are allowed to receive advanced care despite poor prognosis leading to futile treatment and eventual mortality. However, outcome of ICU care in cancer patients have improved, which calls for a more refined triaging of cancer patients to ICU. Studies that describe the characteristics and outcomes of cancer patients is lacking in our population.
To describe the characteristics of patients with hematological and solid cancers who require ICU admission and to review their outcomes.
We retrospectively collected data from patients with hematological and solid cancers admitted to a large academic ICU unit over a six year period (2011-2016). We excluded patients admitted electively for elective post-oncological surgery care. Logistic regression analyses will be conducted to examine the association between ICU mortality and the following covariates: Age, ICU length of stay (LOS), APACHE score, prior cancer therapy within three months, need of mechanical ventilation (MV), need of renal replacement therapy (RRT), and presence of febrile neutropenia. Survival at 30 and 90 days will be measured. Stepwise selection procedure will be used to develop the multivariate logistic model. Kaplan- Meier survival curves will be plotted for both study groups and compared using log-rank test. Two-Tailed p-value of 0.05 will be considered significant.
There were a total of 473 admissions to ICU of patients with cancer. 221 admissions were hematological malignancies and 252 admissions were those with solid tumours. Average LOS in ICU was 9.9 days. Mean age was 51.2 years, whereas mean APACHE scores were 22.4 for hematological and 21.4 for solid tumours. 33.4% of patients had received cancer therapy within 3 months. 74.3% needed MV, and 15% needed RRT. 26.8% were admitted with febrile neutropenia. Overall survival was 40.4% at 30 days, with 37.1% of hematological and 43.3% of solid tumour patients surviving 30 days. Survival decreases at 90 days to 25.6% overall, with similar numbers for hematological and solid tumours (26.2 and 25% respectively).

Outcome of ICU patients with cancer is worse than the average ICU patient but these patients should not be denied ICU aggressive therapy solely based on their cancer status. More refined prognostication models should be constructed to help clinicians caring for oncology patients determine the utility of ICU admission once a need arises.

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