Intensive care admission of cancer patients: a comparative analysis

Abstract

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.

Critical care of patients with cancer

“…Approximately 5% to 10% of patients with cancer will develop a life‐threatening condition that necessitates ICU admission . In a study conducted in France, admission rates for patients with differing cancer entities varied between 0.7% and 12% .…”

“…In a study conducted in France, admission rates for patients with differing cancer entities varied between 0.7% and 12% . 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 .…”

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

“…This study highlights the evolving complexity of oncology patients, with more lines of treatment available to patients and those with metastatic disease surviving longer and maintaining their performance status. A large registry study has suggested as many as one in 16 cancer patients require intensive care during their treatment . Outcomes are comparable with patients with other chronic organ dysfunction .…”

Critérios de admissão do paciente oncológico em Unidades de Terapia Intensiva de hospitais gerais

“…Ainda concernente às admissões de pacientes em UTI, estudo holandês [8] demonstrou que mesmo por razões clínicas, o suporte intensivo para pacientes com câncer não deve ser considerado dispensável.…”

“…O tipo de câncer mostrou-se como fator influenciador da taxa de mortalidade em três estudos [8,11,12] e a idade influenciou em uma pesquisa [12].…”