Oncological patients admitted to an intensive care unit. Analysis of predictors of in-hospital mortality.

OBJECTIVE

To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU).

DESIGN

A retrospective observational study was carried out.

SETTING

The ICU of a community hospital.

PATIENTS

Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h.

INTERVENTIONS

Review of clinical data.

VARIABLES OF INTEREST

Referring ward and length of stay prior to admission to the ICU, type of tumor, extent, Eastern Cooperative Oncology Group (ECOG) score, reason for ICU admission, severity (SOFA, APACHE-II, SAPS-II), type of therapy received in the ICU, and in-hospital mortality.

RESULTS

A total of 167 patients (mean age 71.1 years, 62.9% males; 79% solid tumors) were included, of which 61 (36%) died during their hospital stay (35 in the ICU). The factors associated to increased in-hospital mortality were ECOG scores 3-4 (OR 7.23, 95%CI: 1.95-26.87), metastatic disease (OR 3.77, 95%CI: 1.70-8.36), acute kidney injury (OR 3.66, 95%CI: 1.49-8.95) and SOFA score at ICU admission (OR 1.26, 95%CI: 1.10-1.43). A total of 60.3% of the survivors were independent at hospital discharge.

CONCLUSIONS

In our series, only one-third of the critically ill cancer patients admitted to the ICU died during hospital admission, and more than 50% showed good performance status at hospital discharge. The clinical prognostic factors associated to in-hospital mortality were poor performance status, metastatic disease, SOFA score at ICU admission and acute kidney injury.