Monitoring/OutcomesPrognostic factors in critically ill cancer patients admitted to the intensive care unit
Introduction
The growing number of patients living with cancer leads to a similar increase in the number of patients requiring intensive care. Despite the general opinion that admission of cancer patients to intensive care units (ICUs) is usually futile and costly based on some older studies, ICU survival has been reported to be improved significantly in recent studies [1], [2], [3], [4]. Increased survival expectancy in critically ill cancer patients led conduction of studies that investigate the prognostic factors that predict ICU outcome and guide ICU admission and management strategies [1], [2], [3], [4], [5], [6], [7], [8]. We, therefore, analyzed our data retrospectively to determine the characteristics and outcomes of cancer patients admitted to our medical ICU and to identify the risk factors associated with ICU mortality.
Section snippets
Study design
This study is a retrospective, observational study conducted in the 9-bed medical ICU of the Gazi University Hospital, a 1000-bed university hospital in Ankara, Turkey. Every adult patient (≥ 18 years old) with histologically proven cancer who required ICU admission was evaluated between January 1, 2009, and June 30, 2012. When ICU admission is considered in a cancer patient in our center, life expectancy should be longer than 3 months, and/or further treatment options to treat the underlying
Results in the whole study cohort
There were 1130 admissions during the study period, among whom 162 (14.3%) were cancer patients who met the eligibility criteria of the study. Median age was 61 (48-71.3) years, and most patients were male (58.6%). The most common causes of ICU admission were sepsis/septic shock (66.7%) and respiratory failure (63.6%). The most common comorbidities of the patients were cardiovascular diseases, diabetes, and hypertension. Most patients were admitted to our medical ICU from emergency service. Two
Discussion
There is growing number of ICU admissions of cancer patients in parallel to the increase in patients living with cancer. Patients with cancer are more severely ill than the patients without cancer, resulting in higher ICU and hospital mortality rates. Similarly, our ICU mortality rate in cancer patients was 55% and higher than the overall mortality of 32%. Previous studies have reported ICU mortality between 10% and 70% in cancer patients. This large interstudy variation in the mortality rates
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