536P Characteristics and outcome of cancer patients with sepsis requiring admission to the intensive care unit

Abstract

Background Cancer patients have a nearly 10-fold risk of developing sepsis compared with patients without malignancy. Sepsis is the leading cause of ICU admission in cancer patients. Until the end of the previous century it remained controversial to admit cancer patients to the ICU for advanced-life-supporting therapy. However, over the past few years several center over the world have shown that it is possible to achieve a meaningful survival in these patients. The objective of this study is to assess the characteristics and outcomes in cancer patients admitted to the intensive care unit (ICU) for sepsis. Methods We performed a retrospective cohort study among cancer patients admitted to the ICU for sepsis in Moewardi Hospital between April 2015- April 2016. Every adult patient with a definite diagnosis of cancer and presenting with sepsis at ICU admission was evaluated. Medical history, physical and laboratory findings on admission, and therapeutic interventions during ICU stay were recorded. The main outcome was ICU mortality Results Of the 311 patients admitted to ICU for Sepsis, 40 (12,9%) patients had a definite diagnosis of cancer. Hematologic malignancy (mostly non hodgkin lymphoma and multiple myeloma) affected 35% (N = 14), and solid tumors(mostly cervical cancer and colorectal cancer) affected 65% (N = 26) patients. Mean age was 53 years (SD 14.3), 55% were female.The most frequent sites of infection were the lungs (35%), urinary tract (27.5%) and intra-abdominal region (22%).The median length of stay was 5 days. Eleven patients (27%) developed an Acute Kidney Injury (AKI) during their ICU stay. AKI occurred significantly more frequent in solid tumor patient as compared to hematologic malignancy patients (90,9% vs 9,1%, p < 0,05). Overall ICU mortality rate was 52.5%. There was no significant difference in ICU mortality rates between patients with hematologic malignancies and solid tumors (64.3% vs 46,2%, p = 0.273) Conclusions Sepsis is a common cause of critical illness in patients with cancer and associated with high mortality. Overall ICU mortality rate was 52.5%. We found that ICU mortality rates of patients with hematologic malignancies and solid tumors were similar Legal entity responsible for the study Department of Internal Medicine, Faculty of Medicine, Sebelas Maret University- Moewardi Hospital, Surakarta, Indonesia Funding Department of Internal Medicine, Faculty of Medicine, Sebelas Maret University- Moewardi Hospital, Surakarta, Indonesia Disclosure All authors have declared no conflicts of interest.