Survival in solid cancer patients following intensive care unit admission

Puxty, Kathryn; McLoone, Philip; Quasim, Tara; Kinsella, John; Morrison, David S.

doi:10.1007/s00134-014-3471-9

Cited by 127 publications

(105 citation statements)

References 59 publications

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“…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].…”

Section: Discussionmentioning

confidence: 83%

Focus on immunocompromised patients

2016

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Section: Discussionmentioning

confidence: 83%

Focus on immunocompromised patients

2016

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“…It is likely that patients with cancer have yielded benefit from the technical progress in intensive care medicine in the same way as patients with other diseases. Conversely, admission to the ICU during an acute episode remains associated with a higher mortality rate than admissions arising from scheduled surgery (3,4,11,12).…”

Section: Introductionmentioning

confidence: 99%

What are the ethical aspects surrounding intensive care unit admission in patients with cancer?

Rigaud¹,

Large²,

Meunier-Beillard³

et al. 2017

Ann. Transl. Med.

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Improvements in living conditions and increasing life expectancy have combined to result in ever older patients being admitted to hospital. In parallel, the increasing incidence of cancer, along with the improved efficacy of anti-cancer therapies has led to greater needs for intensive care among cancer patients.The objectives underpinning the management of cancer patients in the intensive care unit (ICU) are to achieve a return to a clinical status that would allow the patient to be either, transferred back to the original unit, or discharged from the hospital with an acceptable quality of life, and where warranted, pursuit of cancer therapy. The relevance of ICU admission should be assessed systematically for patients with active cancer. The decision needs to be made taking into account the expected benefit for the patient, the lifesupport therapies that are possible with discussion about a care project, and also considering the future quality of life and the short and long-term prognosis. Anticipating the question of potential ICU admission should help protect the patient against both inappropriate refusal of intensive care, and inappropriate admission to the ICU that might only lead to unreasonable therapeutic obstinacy. The intensive care physician has a major role to play in helping the cancer patient to develop an appropriate and flexible healthcare project. Anticipating the question of ICU admission in advance, as well as a close alliance between the oncologist and the intensive care physician are the two keys to the success of a healthcare project focused on the patient.

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“…Several studies have reported comparable ICU and hospital survival rates among critically ill patients with and without malignancy (1,2). This observation has led to a reappraisal of ICU admission policy for these patients.…”

mentioning

confidence: 97%

“…This is explained, at least in part, by the marked heterogeneity of the populations studied (1)(2)(3)(4)6,7). In a recent systematic review of 45 studies reporting on outcomes of critically ill patients with solid tumors, ICU mortality rates ranged from 4.5% to 85% (2).…”

mentioning

confidence: 99%