Survival of patients with cancer in a medical critical care unit.

The records of 40 patients with cancer and 684 patients without cancer admitted to a medical critical care unit were reviewed for the purpose of comparing survival. Patients with cancer had a higher mortality (55%, 22/40) than the patients without cancer (17%, 118/864). Patients with cancer and respiratory failure had a higher mortality (75%, 18/24) than patients without cancer but with respiratory failure (25%, 66/273) and a higher mortality than patients with cancer but without respiratory failure (25%, 4/16). In patients with cancer, the manifestation of respiratory failure as the adult respiratory distress syndrome (ARDS) was associated with a high mortality (86%, 12/14), which was not statistically higher than in patients with cancer with non-ARDS respiratory failure (60%, 6/10) or in patients without cancer with ARDS (65%, 28/43). Patients with cancer but without respiratory failure had a mortality of 25% (4/16). All eight patients with cancer admitted to the hospital because of life-threatening metabolic disturbances survived. In deciding whether to apply critical care techniques to a patient with cancer, the physician should consider the specific nature of the life-threatening illness.