Critically ill cancer patients in the intensive care unit: short-term outcome and 1-year mortality

Acta Anaesthesiol Scand. 2012 Feb;56(2):178-89. doi: 10.1111/j.1399-6576.2011.02579.x. Epub 2011 Dec 12.

Abstract

Background: The short-term survival of critically ill patients with cancer has improved over time. Studies providing long-term outcome for these patients are scarce.

Methods: We prospectively analyzed outcomes and rates of successful discharge of 111 consecutive critically ill cancer patients admitted to intensive care unit (ICU) in 2008 and identified factors influencing these results.

Results: ICU mortality was 32% and hospital mortality was 41%. None of the characteristics of the malignancy nor age or neutropenia were significantly different between survivors and others. Two variables were independently associated with ICU mortality: high Logistic Organ Dysfunction score on day 7 and a diagnosis of viral infection and/or reactivation. The 1-year mortality rate for ICU survivors was 58% and was significantly lower in patients with a diagnosis of acute leukemia or multiple myeloma.

Conclusion: Organ failure scores on day 7 can predict outcome for cancer patients in the ICU. Viral infection and reactivation appear to worsen the prognosis. One-year mortality rate is high and depends on the malignancy.

MeSH terms

  • APACHE
  • Aged
  • Comorbidity
  • Critical Care*
  • Critical Illness / mortality*
  • Female
  • Hospital Mortality
  • Humans
  • Infections / microbiology
  • Infections / mortality
  • Infections / virology
  • Intensive Care Units
  • Length of Stay
  • Lod Score
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality
  • Neoplasms / complications
  • Neoplasms / mortality*
  • Neoplasms / therapy*
  • Patient Discharge
  • Prognosis
  • Prospective Studies
  • Respiratory Insufficiency / etiology
  • Survival Analysis
  • Survivors
  • Treatment Outcome