The decision to transfer patients (pts) with solid cancer tumours to an intensive care unit (ICU) is still controversial and difficult. Few studies have assessed the outcome for these patients. The aim of this study was to identify 30-day prognostic factors/mortality for pts with solid cancer tumours admitted to an ICU.
We conducted a retrospective cohort study of all consecutive pts with solid cancer tumours admitted to ICUs at Bordeaux University Hospital, between January 2010 and December 2015. The study end point was 30-day mortality. Secondary end points were to describe the characteristics and outcomes for pts, and ethical practices.
We included 235 patients with solid tumours. Most of them were in a metastatic setting (60%).The most common causes for ICU admission were sepsis (56%) and/or respiratory failure (52%). ICU, 30-day, 90-day mortality rates were 24%, 36% and 50% respectively. After ICU stay, 44% of pts had restarted an anti-tumoral treatment. In multivariate analysis and after excluding SAPS 2 score, two or more organ failures (p = .005) and being under non-curative care (p = 0.028) were independent prognostic factors of 30-day mortality. A support person was designated in 81% of cases, advance directives expressed in 2% and collective decision reported in 21%. Limitation of life-sustaining therapy was decided for 23% and 43% of pts before admission and during the ICU stay, respectively.
The number of organ failures is a rapidly assessable variable that can help oncologists and intensive care specialists in their decision. A support person is often designated but advance directives are still unusual.
Clinical trial identification
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Has not received any funding.
All authors have declared no conflicts of interest.