Short- and long-term outcomes of critically ill patients with cancer and prolonged ICU length of stay.

Abstract:

BACKGROUND:Data on patients with cancer who have a prolonged length of stay (LOS) in the ICU are scarce. The aim of the present study was to evaluate the characteristics and the outcomes of cancer patients with life-threatening complications with an ICU stay > or = 21 days. METHODS:A cohort study performed at a 10-bed oncology medical-surgical ICU from May 2000 to December 2005. Prolonged ICU LOS was defined as an ICU stay > or = 21 days. RESULTS:During the period, 1,090 patients were admitted to the ICU and 163 patients (15%) had a prolonged ICU LOS. These patients, however, accounted for 48% (5,828/12,224) of the total ICU bed-days. The hospital and 6-month mortality rates were 50% and 60%, respectively, and similar to patients with ICU LOS < 21 days (51% and 61%, respectively). ICU-acquired events and complications were common, and the most frequent were infections (90%), mechanical ventilation (99%), and need for vasopressors (88%). The number of organ failures, older age, and poor performance status were the main outcome predictors. The median long-term follow-up after hospital discharge was 537 days (range, 193 to 1,119 days), and 29 patients (18%) were alive. CONCLUSIONS:Fifteen percent of critically ill patients with cancer had a prolonged ICU LOS. Short- and long-term survival rates were reasonable, and the prognosis was better than expected a priori. In our opinion, the length of ICU admission per se should not be used in the clinical decisions regarding the continuation of treatment in these patients.

journal_name

Chest

journal_title

Chest

authors

Soares M,Salluh JIF,Torres VBL,Leal JVR,Spector N

doi

10.1378/chest.08-0359

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

520-526

issue

3

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(08)60250-0

journal_volume

134

pub_type

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