Abstract 1726P
Background
New cancer treatments have improved life prognosis in oncology, leading to an increasing demand for critical care attention and complexity in clinical decisions. We aim to assess the outcomes and prognosis of cancer patients (pts) admitted to the Intensive Care Unit (ICU) since there is limited data about clinical predictors for mortality in this setting.
Methods
This is a retrospective study of pts with solid malignancies non-electively admitted to the Hospital Clinic of Barcelona ICU between 01/2019-12/2019. Clinical and laboratory data were collected. The primary endpoints were mortality at 1, 3 and 6 months (m); comparison between different groups was performed by the chi-squared test.
Results
97 pts with a mean age of 63.8 years (SD 11.7) were included, 54% were male. Lung was the most frequent primary cancer (22.6%), followed by colorectal (16.4%) and breast (12.3%). Most pts (79.4%) presented metastatic disease and were receiving active oncologic treatment (75.3%) being chemotherapy the most frequent modality (51%). In 12.5% of the pts, cancer was diagnosed during the same hospital admission. Respiratory failure was the main cause for ICU admission (38%; 13.4% required mechanical ventilation), followed by septic shock (36%). Median APACHE II and SOFA scores at admission were 13 and 4, respectively. Mortality rate at 1m was 15.5%, 37.1% at 3m and 56.7% at 6m. Median overall survival after ICU admission was different between patients with and without metastatic disease (5 vs 14m, p<0.05). Univariate analysis showed that the presence of liver metastasis was significantly correlated with poor prognosis at 1m (mortality 9% vs 29.4%) and 3m (mortality 25.3% vs 61.7%) after hospital admission. Cachexia (defined as hypoalbuminemia <32g/dL or CRP >0.5mg/dL the prior month) was also predictor of higher mortality rates at 1 and 3m (p<0.05). Pts diagnosed during the current admission presented high in-hospital mortality (50%).
Conclusions
Oncologic patients admitted to ICU due to medical complications present high mid-term mortality. Cachexia and liver metastasis were associated with higher 3 months mortality. A better understanding of clinical prognostic factors would help to develop proper admission criteria.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hospital Clínic y Provincial de Barcelona.
Funding
Has not received any funding.
Disclosure
P. Castro: Financial Interests, Personal, Other, Honoraria for scientific collaboration: Pfizer; Financial Interests, Personal, Other, Honoraria for scientific collaboration: MSD; Financial Interests, Personal, Other, Honoraria for Scientific Collaboration: Gilead; Financial Interests, Personal, Other, Honoraria For Scientific Collaboration: Kyte; Financial Interests, Personal, Advisory Board: Alexion; Financial Interests, Personal, Advisory Board: Jansen; Financial Interests, Personal, Advisory Board: Gilead. A. Prat: Financial Interests, Personal, Other, Immediate Family Member : Novartis; Financial Interests, Personal, Ownership Interest: Pfizer; Financial Interests, Personal, Ownership Interest: Novartis; Financial Interests, Personal, Ownership Interest: Roche; Financial Interests, Personal, Ownership Interest: MSD; Financial Interests, Personal, Ownership Interest: Lilly; Financial Interests, Personal, Ownership Interest: Daiichi Sankyo; Financial Interests, Personal, Other, Travel And Accommodations : Daiichi Sankyo; Financial Interests, Personal, Funding: Roche; Financial Interests, Personal, Funding: Novartis; Financial Interests, Personal, Advisory Role: NanoString Technologies; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Roche; Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Advisory Role: Bristol-Myers Squibb. All other authors have declared no conflicts of interest.