Abstract
To examine the demographics, evolution and outcome of patients suffering from malignancies admitted to a medical intensive care unit. Single centre retrospective cohort study of patients with malignancies. Data on demographics, diagnosis laboratory tests, provided therapy and outcome were retrospectively collected. Data was analysed for differences between patients suffering from solid compared to haematological malignancies as well as for predictors of one year survival. A total of 74 consecutive patients with a median age of 62 years were enrolled. From these, 42 (57%) suffered from solid and 32 (43%) from haematological malignancies. In total, 64% of patients with solid malignancies presented with metastatic disease. The main reason for intensive care unit admission in patients with solid malignancies was acute cardiovascular failure (39%) and infections in patients with haematological malignancies (38%). Intensive care unit mortality, hospital mortality and one year mortality were 26%, 35% and 71% overall; 17%, 29% and 69% respectively in patients with solid and 38%, 44% and 73% respectively in patients with haematological malignancies. Survival was close to 40% in patients with no or one organ failure. Survival dropped to 20% with 2 and 13% with ≥3 organs in failure. The number of organs in failure predicted hospital fatality with an AUCRoc of 0.87. The number of failing organs rather than malignancy itself drives outcome even in patients with malignancies. Thus the number of organs in failure rather than diagnosis should guide intensive care unit management in patients with malignancies.
Highlights
Malignancy together with treatment related side effects cause substantial morbidity and mortality
To examine the demographics, evolution and outcome of patients suffering from malignancies admitted to a medical intensive care unit
Data was analysed for differences between patients suffering from solid compared to haematological malignancies as well as for predictors of one year survival
Summary
Malignancy together with treatment related side effects cause substantial morbidity and mortality. Mechanical ventilation was shown to largely deteriorate outcome in haematological patients [7–10] and was found to almost always result in fatality in patients who received bone marrow- or stem cell transplantation [11–17]. This was the case if the pulmonary complication occurred within fewer than 90 days after transplantation [18], or occurred after the engraftment period in the context of graft versus host disease [19]. In patients with solid and haematological malignancies at our institution we looked at the current base line characteristics, the therapy they received as well as their outcome. Data obtained was analysed to identify the most appropriate indicator to drive ICU treatment in regard to survival at one year after hospital admission
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
