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01-11-2021 | Care | Gastrointestinal Oncology

A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery

Authors: Bourke W. Tillmann, MD, Julie Hallet, MD, Matthew P. Guttman, MD, Natalie Coburn, MD, Tyler Chesney, MD, Jesse Zuckerman, MD, Alyson Mahar, PhD, Victoria Zuk, MHSc, Wing C. Chan, MPH, Barbara Haas, MD, and members of the REcovery after Surgical Therapy for Older adults Research—Cancer (RESTORE-C) group

Published in: Annals of Surgical Oncology | Issue 12/2021

Abstract

Background

High-intensity cancer surgery is increasingly common among older adults. However, these patients are at high-risk for unexpected intensive care unit (ICU) admissions after surgery. How these admissions impact older adults’ long-term outcomes is unknown.

Methods

We performed a population-based, cohort study of older adults (age ≥ 70 years) who underwent high-intensity cancer surgery from 2007 to 2017. Analyses were performed to examine time alive and at home following surgery, defined as time from surgery to nursing home admission or death. Patients were followed for up to 5 years. Extended Cox proportional hazards models examined the independent association between unexpected ICU admission (ICU admissions excluding routine postoperative monitoring) and remaining alive and at home. Subgroup analysis stratified patients by duration of mechanical ventilation (MV).

Results

Of 47,367 identified older adults, 7372 (15.6%) had an unexpected ICU admission. Patients with an unexpected ICU admission had a significantly lower probability of being alive and at home at 5 years (26.2%; 95% confidence interval [CI] 25.1–27.2%) compared with those without an unexpected admission (56.8%; 95% CI 56.3–57.4%). After adjusting for baseline characteristics, unexpected ICU admission remained associated with less time alive and at home. The elevated risk of death or nursing home admission persisted for 5 years after surgery (years 2–5: hazard ratio [HR] 1.58, 95% CI 1.50–1.66). Duration of MV was inversely associated with time alive and at home.

Conclusions

Older adults with an unexpected ICU admission after high-intensity cancer surgery are at increased risk for death or admission to a nursing home for at least 5 years.

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Title: A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery
Authors: Bourke W. Tillmann, MD
Julie Hallet, MD
Matthew P. Guttman, MD
Natalie Coburn, MD
Tyler Chesney, MD
Jesse Zuckerman, MD
Alyson Mahar, PhD
Victoria Zuk, MHSc
Wing C. Chan, MPH
Barbara Haas, MD
and members of the REcovery after Surgical Therapy for Older adults Research—Cancer (RESTORE-C) group
Publication date: 01-11-2021
Publisher: Springer International Publishing
Keyword: Care
Published in: Annals of Surgical Oncology / Issue 12/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-021-10705-8

2024 ASCO Annual Meeting

Springer Medicine

A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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