TY  - JOUR
IS  - 10
N1  - This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
TI  - Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: A retrospective analysis
AV  - public
VL  - 6
Y1  - 2016/10//
JF  - BMJ Open
A1  - Fisher, R
A1  - Dangoisse, C
A1  - Crichton, S
A1  - Whiteley, C
A1  - Camporota, L
A1  - Beale, R
A1  - Ostermann, M
N2  - OBJECTIVES: Patients with cancer frequently require unplanned admission to the intensive care unit (ICU). Our objectives were to assess hospital and 180-day mortality in patients with a non-haematological malignancy and unplanned ICU admission and to identify which factors present on admission were the best predictors of mortality.

DESIGN: Retrospective review of all patients with a diagnosis of solid tumours following unplanned admission to the ICU between 1 August 2008 and 31 July 2012.

SETTING: Single centre tertiary care hospital in London (UK).

PARTICIPANTS: 300 adult patients with non-haematological solid tumours requiring unplanned admission to the ICU.

INTERVENTIONS: None.

PRIMARY AND SECONDARY OUTCOMES: Hospital and 180-day survival.

RESULTS: 300 patients were admitted to the ICU (median age 66.5?years; 61.7% men). Survival to hospital discharge and 180?days were 69% and 47.8%, respectively. Greater number of failed organ systems on admission was associated with significantly worse hospital survival (p<0.001) but not with 180-day survival (p=0.24). In multivariate analysis, predictors of hospital mortality were the presence of metastases (OR 1.97, 95% CI 1.08 to 3.59), Acute Physiology and Chronic Health Evaluation II (APACHE II) Score (OR 1.07, 95% CI 1.01 to 1.13) and a Glasgow Coma Scale Score <7 on admission to ICU (OR 5.21, 95% CI 1.65 to 16.43). Predictors of worse 180-day survival were the presence of metastases (OR 2.82, 95% CI 1.57 to 5.06), APACHE II Score (OR 1.07, 95% CI 1.01 to 1.13) and sepsis (OR 1.92, 95% CI 1.09 to 3.38).

CONCLUSIONS: Short-term and medium-term survival in patients with solid tumours admitted to ICU is better than previously reported, suggesting that the presence of cancer alone should not be a barrier to ICU admission.
ID  - discovery10038968
UR  - http://dx.doi.org/10.1136/bmjopen-2016-011363
SN  - 2044-6055
ER  -