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ePoster Display

1725P - Outcomes of cancer patients after ICU admission: Beyond mortality data

Date

16 Sep 2021

Session

ePoster Display

Presenters

Marta Garcia De Herreros

Citation

Annals of Oncology (2021) 32 (suppl_5): S1175-S1198. 10.1016/annonc/annonc714

Authors

M. Garcia De Herreros1, J.C. Laguna Montes1, J. Padrosa1, T.D. Barreto Zambrano2, C. Zamora1, M. Viladot1, T. Gorria1, L. Fernandez-Mañas1, L. Ghiglione1, E. Segui Solis1, I. Casablancas1, A. Marin1, A. Pascual1, S. Fernandez-Mendez3, A. Téllez3, P. Castro3, J.M. Nicolas3, A. Tuca1, A. Prat1, J. Marco-Hernández1

Author affiliations

  • 1 Medical Oncology Department, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 2 Radiation Oncology Department, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 3 Medical Intensive Care Unit, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
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Abstract 1725P

Background

New cancer treatments have improved life prognosis in oncology, leading to an increasing demand for critical care attention and complexity in clinical decisions. There is poor data regarding outcomes in cancer patients after Intensive Care Unit (ICU) admissions, especially beyond mortality data. We aim to assess the impact that ICU admission represents in terms of deterioration of performance status (PS) and cancer treatment discontinuation, among others.

Methods

This is a retrospective study of patients with solid malignancies non-electively admitted to the Hospital Clinic of Barcelona ICU between 01/2019 and 12/2019. Clinical and laboratory data were collected. Data are expressed in mean (SD) or number (%). Statistical analysis was carried out with SPSS.

Results

Ninety-seven patients with a mean age of 64 years (SD 11.7) were included and 54% were male. Lung was the most frequent primary cancer (22.6%), followed by colorectal (16.4%) and breast (12.3%). Median PS evaluated before ICU admission was 1 (74% of pts 0-1, 25% 2 and 1% 3-4), Karnofsky Index (KI) score was 82 and Barthel Index (BI) 90. Most patients had a metastatic disease at ICU admission (79.4%), being 75% under some type of oncospecific treatment. Their median ICU and in-hospital length of stay were 4 days (IQR 2-6) and 25 days (IQR 11-34), respectively. ICU mortality rate was 9.4% and in-hospital mortality was 24%, being 56.7% at 6 months. End of life care decisions were made during the hospitalization in 32% of the patients. PS, KI and BI scores significantly decreased after ICU admission, with median values of 2.7, 47 and 70, respectively at hospital discharge (p<0.05). 11.3% of the patients needed admission in a socio-sanitary centre and 40% were admitted at the hospital at least once more time in the following 6 months (11.3% requiring ICU again). In 29% of patients, cancer progressed during the hospitalization. Oncospecific treatment was discontinued in 37% of the patients, modified or reduced in 56.7% and changed in 20% of the cases.

Conclusions

ICU admission is associated to high mid-term mortality in cancer patients, as well as significant deterioration in PS, KI and BI scores, leading to changes in oncospecific therapies and definitive treatment discontinuation.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hospital Clinic Barcelona, Spain.

Funding

Has not received any funding.

Disclosure

P. Castro: Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Advisory Board: Alexion. A. Prat: Financial Interests, Personal, Ownership Interest: Novartis; Financial Interests, Personal, Ownership Interest: Pfizer; 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, Funding: Roche; Financial Interests, Personal, Funding: Novartis; Financial Interests, Personal, Funding: 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.

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