Has survival increased in cancer patients admitted to the ICU? No

Managing critically Ill hematology patients: Time to think differently

“…In patients receiving mechanical ventilation (MV), mortality ranges from 35% to 70% depending on the associated organ dysfunctions and presence of graft versus host disease (GVHD) [17]. Mortality in patients with HMs and septic shock has fallen by 30% [18,19]. Non-bone marrow transplant (BMT) recipients with HMs requiring renal replacement therapy (RRT) have the same long-term outcomes as do patients without malignancies [20,21].…”

Has survival increased in cancer patients admitted to the ICU? We are not sure

“…In other words, triage decisions solely based on the type of underlying comorbidity is becoming obsolete. By defending the con viewpoint, Pène et al [8] somewhat attenuates this optimism by focusing on the fact that current survival rates are still based on studies performed in heterogeneous populations coming from different centers with different experiences and cultures. Therefore, it seems naïve to recommend broad ICU admission policies or full code status for any patient with cancer and acute organ dysfunction.…”

“…Interestingly, both Mokart et al [1] and Pène et al [8] highlight that we need to learn how to make appropriate triage decisions taking into account the burden of aggressive intensive care, expected short-term outcomes, cancer outcomes, and long-term outcomes. This requires, however, much more than pure medical skills or scientific knowledge.…”

Focus on immunocompromised patients

“…In a systematic review of patients with solid tumors, 35 studies (25,339 patients) reported ICU and hospital mortality rates of 31.2 and 38.2 %, respectively [12]. These studies confirm the impact of performance status and mechanical ventilation on mortality, but also the lack of prognostic value of variables depicting the characteristics of the malignancy [13][14][15]. Clinical consequences of these findings are of paramount importance.…”