One-year survival in patients with solid tumours discharged alive from the intensive care unit after unplanned admission: A retrospective study

J Crit Care. 2020 Jun:57:36-41. doi: 10.1016/j.jcrc.2020.01.027. Epub 2020 Jan 30.

Abstract

Purpose: Outcomes in cancer patients after unplanned ICU admission was reassessed.

Methods: retrospective cohort of patients with solid tumours admitted to ICU over a 10 years period.

Results: 622 patients (age 62 [53-70]) were analysed. The most common primary sites of cancer were lung (n = 133; 21.4%) and digestive tract (n = 126; 20.2%) The ICU mortality rate was 22.2% (n = 138). Among 470 ICU survivors, the 1-year mortality was 41.3% (95% CI, 36-45.9) (n = 167). Factors independently associated with 1-year mortality were ICU admission after 2010 (HR 0.53 (0.37-0.76), p < .001), disease status (respectively, HR = 1.88 (1.0.2-3.45), p = .002) for locally advanced cancer and HR = 2.23 (1.35-3.67), p = .003) for metastatic cancer), poor performance status (HR = 1.58 (1.08-2.31), p = .019), newly diagnosed cancer at ICU admission (HR = 2.02 (1.28-3.20), p = .003), inability to receive oncologic treatment after ICU discharge (HR = 5.34 (3.49-8.18), p < .001) and decision to withhold life-sustaining treatment during ICU stay (HR = 2.34 (1.50-3.65), p < .001).

Conclusions: Among the factors associated with one-year mortality after ICU discharge, the possibility of receiving oncologic treatment after ICU discharge seems crucial.

Keywords: ICU; Long-term follow-up; Outcome; Solid tumours.

MeSH terms

  • Aged
  • Critical Care / methods*
  • Female
  • Hospital Mortality*
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasms / mortality*
  • Neoplasms / therapy*
  • Patient Discharge
  • Retrospective Studies
  • Survivors
  • Treatment Outcome
  • Withholding Treatment