Outcomes in cancer patients (pts) admitted to a surgical (SICU) or medical ICU (MICU) compared to a newly opened cancer specific ICU (HICU).

Abstract

279 Background: The University of Utah opened a cancer specific ICU (HICU) in 2011 admitting medical and surgical cancer pts. Prior to this, medical cancer pts were admitted to the MICU while the SICU admitted both and medical and surgical pts. The primary objective of this study was to compare the quality metrics of mortality and length of stay (LOS). Methods: Pts with a cancer diagnosis and admitted to the MICU or SICU from 2009-2011 or the HICU from 2011-2013 were evaluated. Pts were stratified by ICU type and the HICU was also analyzed by excluding post-operative pts (HICU-MED). Survival from admission, hospital and ICU mortality, and LOS was assessed. Results: A total of 1,375 pts were included with 259 (19%), 416 (30%), and 700 (51%) pts admitted to the MICU, SICU, and HICU, respectively. The median age was 62 years (range 18-91 years) and 57% (n = 787) were male; no significant differences in age (p = 0.1975) and sex (p = 0.7681) were observed between ICU’s. Cancer classification was oncology (65%, n = 888), hematology (32%, n = 435), and BMT (4%, n = 52). Of all pts admitted to the HICU, 44% (n = 308) were post-operative and excluded from HICU-MED (n = 392). See table for survival and LOS comparisons. Conclusions: No differences in overall survival and hospital morality (ICU and out-of-ICU) were observed comparing pts admitted to the HICU vs SICU and HICU-MED vs MICU. ICU-free days were significantly shorter resulting in shorter hospitalizations for the HICU vs SICU, which may have contributed to the reduced 30-day mortality in pts admitted to the HICU. [Table: see text]