Epidemiology and prognosis of patients with a history of cancer admitted to intensive care. A multicenter observational study

Abstract

Objective: To assess the epidemiology and outcome at discharge of cancer patients requiring admission to the Intensive Care Unit (ICU).

Design: A descriptive observational study was made of data from the ENVIN-HELICS registry, combined with specifically compiled variables. Comparisons were made between patients with and without neoplastic disease, and groups of cancer patients with a poorer outcome were identified.

Setting: Intensive Care Units participating in ENVIN-HELICS 2018, with voluntary participation in the oncological registry.

Patients: Subjects admitted during over 24 h and diagnosed with cancer in the last 5 years.

Primary endpoints: The general epidemiological endpoints of the ENVIN-HELICS registry and cancer-related variables.

Results: Of the 92 ICUs with full data, a total of 11,796 patients were selected, of which 1786 (15.1%) were cancer patients. The proportion of cancer patients per Unit proved highly variable (1%-48%). In-ICU mortality was higher among the cancer patients than in the non-oncological subjects (12.3% versus 8.9%; p < .001). Elective postoperative (46.7%) or emergency admission (15.3%) predominated in the cancer patients. Patients with medical disease were in more serious condition, with longer stay and greater mortality (27.5%). The patients admitted to the ICU due to nonsurgical disease related to cancer exhibited the highest mortality rate (31.4%).

Conclusions: Great variability was recorded in the percentage of cancer patients in the different ICUs. A total of 46.7% of the patients were admitted after undergoing scheduled surgery. The highest mortality rate corresponded to patients with medical disease (27.5%), and to those admitted due to cancer-related complications (31.4%).

Keywords: Epidemiology; Epidemiología; Intensive care unit; Mortalidad; Mortality rate; Oncological patients; Paciente oncológico; Unidad de cuidados intensivos.