Survival in solid cancer patients following intensive care unit admission

Intensive Care Med. 2014 Oct;40(10):1409-28. doi: 10.1007/s00134-014-3471-9. Epub 2014 Sep 16.

Abstract

Purpose: One in seven patients admitted to intensive care units (ICU) has a cancer diagnosis but evidence on their expected outcomes after admission has not been synthesised.

Methods: Systematic literature review of solid cancer adult patients admitted to ICU from 2000 onwards using EMBASE and MEDLINE electronic databases.

Results: There were 48 papers identified that reported survival in ICU patients with solid cancers. ICU mortality was reported in 35 studies comprising a total sample of 25,339 patients and ranging from 4.5 to 85 %. The average mortality of the distribution of reported mortality rates within ICU was 31.2 % (95 % CI 24.0-39.0 %). Hospital mortality was reported in 31 studies across a total sample of 74,061 patients. The average hospital mortality was 38.2 % (33.8-42.7 %) and ranged from 4.6 to 76.8 %. Poorer physiological score, invasive mechanical ventilation and poor functional status were associated with higher mortality.

Conclusions: Several factors have been associated with poor survival in ICU cancer patients; however, primary research is still needed to describe outcomes in cancer patients with sufficient case mix and treatment details to be of prognostic value to clinicians.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Comorbidity
  • Critical Care / methods
  • Critical Care / statistics & numerical data*
  • Databases, Bibliographic
  • Female
  • Hospital Mortality*
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasms / classification
  • Neoplasms / mortality*
  • Neoplasms / pathology
  • Organ Dysfunction Scores
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Prognosis
  • Regression Analysis
  • Survival Analysis