Outcomes and Prognostic Markers of Patients Admitted to Intensive Care: A Six-Year Analysis


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Kenrick Ng1,Sophie Joury1,Roopinder Gillmore1
1Royal Free Hospital, UK

Abstract

Background

Perceived dismal outcomes for oncology patients requiring life support means that decisions regarding ITU admission are challenging. Discussion whether cancer patients with advanced cancer should be admitted to ICU raises controversy, with concerns about inappropriate use of limited resources on one hand and denial of effective care on the other. Advances in both oncological and intensive care, however, means that much greater numbers of critically ill cancer patients are surviving and benefiting from ITU support. We aim to identify the prognostic factors that can be used to predict outcomes for cancer patients requiring intensive care.

Method

Data was collected retrospectively for all oncology patients with solid-organ tumours requiring emergency admission to the Royal Free Hospital ITU from 2009-2015. Survival rates were determined and analysed in light of different prognostic factors including age, degree of multiorgan-failure, metastases, sepsis and neutropenia.

Results

31 patients were identified with an ITU mortality of 6.5% and 6-month survival of 48.3%. Age, neutropenia and sepsis did not affect outcomes post-ITU. Organ-failure and metastases, however, both reduced survival. Survival was 86% in the absence of organ failure and 25% with 3-organ failure, whilst metastases reduced survival by 10%.

Conclusion

Survival of oncology patients requiring intensive care is better than suggested in previous studies. Age, neutropenia and sepsis do not reduce survival unlike organ-failure and metastases. Identification of these prognostic factors will mean better selection and enhanced outcomes for cancer patients requiring ITU.

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