Research
Characteristics and outcomes of cancer patients in European ICUs
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* Corresponding author: Jean-Louis Vincent jlvincen@ulb.ac.be
1 Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, 1070-Brussels, Belgium
2 Critical Care Center, Sabadell Hospital, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Parc Tauli, 08208 Sabadell, Spain
3 Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, P.O.B. 12000, 91120 Jerusalem, Israel
4 Department for Intensive Care, Hospital de St. Antonio dos Capuchos, Centro Hospitalar de Lisboa Central E.P.E., Alameda de Santo António dos Capuchos, 1169-050 Lisboa, Portugal
5 Department of Anesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 101, Jena 07743, Germany
Critical Care 2009, 13:R15 doi:10.1186/cc7713
Published: 6 February 2009Abstract
Introduction
Increasing numbers of cancer patients are being admitted to the intensive care unit (ICU), either for cancer-related complications or treatment-associated side effects, yet there are relatively few data concerning the epidemiology and prognosis of cancer patients admitted to general ICUs. The aim of this study was to assess the characteristics of critically ill cancer patients, and to evaluate their prognosis.
Methods
This was a substudy of the Sepsis Occurrence in Acutely Ill Patients (SOAP) study, a cohort, multicentre, observational study that included data from all adult patients admitted to one of 198 participating ICUs from 24 European countries during the study period. Patients were followed up until death, hospital discharge or for 60 days.
Results
Of the 3147 patients enrolled in the SOAP study, 473 (15%) had a malignancy, 404 (85%) had solid tumours and 69 (15%) had haematological cancer. Patients with solid cancers had the same severity of illness as the non-cancer population, but were older, more likely to be a surgical admission and had a higher frequency of sepsis. Patients with haematological cancer were more severely ill and more commonly had sepsis, acute lung injury/acute respiratory distress syndrome, and renal failure than patients with other malignancies; these patients also had the highest hospital mortality rate (58%). The outcome of all cancer patients was comparable with that in the non-cancer population, with a 27% hospital mortality rate. However, in the subset of patients with more than three failing organs, more than 75% of patients with cancer died compared with about 50% of patients without cancer (p = 0.01).
Conclusions
In this large European study, patients with cancer were more often admitted to the ICU for sepsis and respiratory complications than other ICU patients. Overall, the outcome of patients with solid cancer was similar to that of ICU patients without cancer, whereas patients with haematological cancer had a worse outcome.