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Intensive Care Medicine

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01-10-2014 | Systematic Review

Survival in solid cancer patients following intensive care unit admission

Authors: Kathryn Puxty, Philip McLoone, Tara Quasim, John Kinsella, David Morrison

Published in: Intensive Care Medicine | Issue 10/2014

Abstract

Purpose

One in seven patients admitted to intensive care units (ICU) has a cancer diagnosis but evidence on their expected outcomes after admission has not been synthesised.

Methods

Systematic literature review of solid cancer adult patients admitted to ICU from 2000 onwards using EMBASE and MEDLINE electronic databases.

Results

There were 48 papers identified that reported survival in ICU patients with solid cancers. ICU mortality was reported in 35 studies comprising a total sample of 25,339 patients and ranging from 4.5 to 85 %. The average mortality of the distribution of reported mortality rates within ICU was 31.2 % (95 % CI 24.0–39.0 %). Hospital mortality was reported in 31 studies across a total sample of 74,061 patients. The average hospital mortality was 38.2 % (33.8–42.7 %) and ranged from 4.6 to 76.8 %. Poorer physiological score, invasive mechanical ventilation and poor functional status were associated with higher mortality.

Conclusions

Several factors have been associated with poor survival in ICU cancer patients; however, primary research is still needed to describe outcomes in cancer patients with sufficient case mix and treatment details to be of prognostic value to clinicians.

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Coleman MP, Rachet B, Woods LM, Mitry E, Riga M, Cooper N, Quinn MJ, Brenner H, Esteve J (2004) Trends and socioeconomic inequalities in cancer survival in England and Wales up to 2001. Br J Cancer 90:1367–1373. doi:10.1038/sj.bjc.6601696 PubMedCrossRefPubMedCentral

Taccone FS, Artigas AA, Sprung CL, Moreno R, Sakr Y, Vincent JL (2009) Characteristics and outcomes of cancer patients in European ICUs. Crit Care 13:R15. doi:10.1186/cc7713 PubMedCrossRefPubMedCentral

Griffiths J, Fortune G, Barber V, Young JD (2007) The prevalence of post traumatic stress disorder in survivors of ICU treatment: a systematic review. Intensive Care Med 33:1506–1518. doi:10.1007/s00134-007-0730-z PubMedCrossRef

Clark D (2002) Between hope and acceptance: the medicalisation of dying. Br Med J 324:1391–1391CrossRef

Garrouste-Orgeas M, Montuclard L, Timsit JF, Reignier J, Desmettre T, Karoubi P, Moreau D, Montesino L, Duguet A, Boussat S, Ede C, Monseau Y, Paule T, Misset B, Carlet J (2005) Predictors of intensive care unit refusal in French intensive care units: a multicentre study. Crit Care Med 33:750–755PubMedCrossRef

Esper AM, Martin GS (2011) The impact of comorbid [corrected] conditions on critical illness. Crit Care Med 39:2728–2735. doi:10.1097/CCM.0b013e318236f27e PubMedCrossRef

Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535. doi:10.1136/bmj.b2535 CrossRef

Brower RG, Matthay MA, Morris A et al (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRef

Kress JP, Pohlman AS, O’Connor MF, Hall JB (2000) Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 342:1471–1477. doi:10.1056/NEJM200005183422002 PubMedCrossRef

10.

Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M, Early Goal-Directed Therapy Collaborative Group (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377. doi:10.1056/NEJMoa010307 PubMedCrossRef

11.

Strengthening the Reporting of Observational studies in Epidemiology (2007). STROBE checklist. http://www.strobe-statement.org/index.php?id=available-checklists Accessed 9 Feb 2014

12.

Adam AK, Soubani AO (2008) Outcome and prognostic factors of lung cancer patients admitted to the medical intensive care unit. Eur Respir J 31:47–53. doi:10.1183/09031936.00031607 PubMedCrossRef

13.

Aldawood AS (2010) Prognosis and resuscitation status of critically ill patients with lung cancer admitted to the intensive care unit. Anaesth Intensive Care 38:920–923PubMed

14.

Andrejak C, Terzi N, Thielen S, Bergot E, Zalcman G, Charbonneau P, Jounieaux V (2011) Admission of advanced lung cancer patients to intensive care unit: a retrospective study of 76 patients. BMC Cancer 11:159. doi:10.1186/1471-2407-11-159 PubMedCrossRefPubMedCentral

15.

Anisoglou S, Asteriou C, Barbetakis N, Kakolyris S, Anastasiadou G, Pnevmatikos I (2013) Outcome of lung cancer patients admitted to the intensive care unit with acute respiratory failure. Hippokratia 17:60–63PubMedPubMedCentral

16.

Azoulay E, Thiery G, Chevret S, Moreau D, Darmon M, Bergeron A, Yang K, Meignin V, Ciroldi M, Le Gall JR, Tazi A, Schlemmer B (2004) The prognosis of acute respiratory failure in critically ill cancer patients. Medicine (Baltimore) 83:360–370CrossRef

17.

Bissell L, Khan OA, Mercer SJ, Somers SS, Toh SK (2013) Long term outcomes following emergency intensive care readmission after elective oesophagectomy. Acta Chir Belg 113:14–18PubMed

18.

Bonomi MR, Smith CB, Mhango G, Wisnivesky JP (2012) Outcomes of elderly patients with stage IIIB-IV non-small cell lung cancer admitted to the intensive care unit. Lung Cancer 77:600–604. doi:10.1016/j.lungcan.2012.05.103 PubMedCrossRef

19.

Bos MM, de Keizer NF, Meynaar IA, Bakhshi-Raiez F, de Jonge E (2012) Outcomes of cancer patients after unplanned admission to general intensive care units. Acta Oncol 51:897–905. doi:10.3109/0284186X.2012.679311 PubMedCrossRef

20.

Caruso P, Ferreira AC, Laurienzo CE, Titton LN, Terabe DS, Carnieli DS, Deheinzelin D (2010) Short- and long-term survival of patients with metastatic solid cancer admitted to the intensive care unit: prognostic factors. Eur J Cancer Care (Engl) 19:260–266. doi:10.1111/j.1365-2354.2008.01031.x CrossRef

21.

Cense HA, Hulscher JB, de Boer AG, Dongelmans DA, Tilanus HW, Obertop H, Sprangers MA, van Lanschot JJ (2006) Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection. Crit Care Med 34:354–362PubMedCrossRef

22.

Chawla S, Pastores SM, Hassan K, Raoof ND, Voigt LP, Alicea M, Halpern NA (2009) ICU admissions after actual or planned hospital discharge incidence, clinical characteristics, and outcomes in patients with cancer. Chest 136:1257–1262. doi:10.1378/chest.08-2909 PubMedCrossRef

23.

Chou KT, Chen CS, Su KC, Hung MH, Hsiao YH, Tseng CM, Chen YM, Lee YC, Perng DW (2012) Hospital outcomes for patients with stage III and IV lung cancer admitted to the intensive care unit for sepsis-related acute respiratory failure. J Palliat Med 15:1234–1239. doi:10.1089/jpm.2012.0084 PubMedCrossRef

24.

Christodoulou C, Rizos M, Galani E, Rellos K, Skarlos DV, Michalopoulos A (2007) Performance status (PS): a simple predictor of short-term outcome of cancer patients with solid tumors admitted to the intensive care unit (ICU). Anticancer Res 27:2945–2948PubMed

25.

Darmon M, Thiery G, Ciroldi M, de Miranda S, Galicier L, Raffoux E, Le Gall JR, Schlemmer B, Azoulay E (2005) Intensive care in patients with newly diagnosed malignancies and a need for cancer chemotherapy. Crit Care Med 33:2488–2493PubMedCrossRef

26.

de Almeida JP, Palomba H, Galas FRBG, Fukushima JT, Duarte FA, Nagaoka D, Torres V, Yu L, Vincent JL, Auler JOC, Hajjar LA (2012) Positive fluid balance is associated with reduced survival in critically ill patients with cancer. Acta Anaesthesiol Scand 56:712–717. doi:10.1111/j.1399-6576.2012.02717.x PubMedCrossRef

27.

Ertan T, Yoldas O, Kilic YA, Kilic M, Gocmen E, Koc M, Tez M (2008) External validation of prognostic models among cancer patients undergoing emergency colorectal surgery. Am J Surg 195:439–441. doi:10.1016/j.amjsurg.2007.03.012 PubMedCrossRef

28.

Jennens RR, Rosenthal MA, Mitchell P, Presneill JJ (2002) Outcome of patients admitted to the intensive care unit with newly diagnosed small cell lung cancer. Lung Cancer 38:291–296PubMedCrossRef

29.

Kopterides P, Liberopoulos P, Ilias I, Anthi A, Pragkastis D, Tsangaris I, Tsaknis G, Armaganidis A, Dimopoulou I (2011) General Prognostic Scores in Outcome Prediction for Cancer Patients Admitted to the Intensive Care Unit. Am J Crit Care 20:56–66. doi:10.4037/Ajcc2011763 PubMedCrossRef

30.

Leath CA 3rd, Kendrick JEt, Numnum TM, Straughn JM, Straughn JM Jr, Rocconi RP, Sfakianos GP, Lang JD Jr (2006) Outcomes of gynecologic oncology patients admitted to the intensive care unit following surgery: a university teaching hospital experience. Int J Gynecol Cancer 16:1766–1769. doi:10.1111/j.1525-1438.2006.00702.x PubMedCrossRef

31.

Lecuyer L, Chevret S, Thiery G, Darmon M, Schlemmer B, Azoulay E (2007) The ICU trial: a new admission policy for cancer patients requiring mechanical ventilation. Crit Care Med 35:808–814. doi:10.1097/01.CCM.0000256846.27192.7A PubMedCrossRef

32.

Liborio AB, Abreu KL, Silva GB Jr, Lima RS, Barreto AG, Barbosa OA, Daher EF (2011) Predicting hospital mortality in critically ill cancer patients according to acute kidney injury severity. Oncology 80:160–166. doi:10.1159/000329042 PubMedCrossRef

33.

Maccariello E, Valente C, Nogueira L, Bonomo H Jr, Ismael M, Machado JE, Baldotto F, Godinho M, Rocha E, Soares M (2011) Outcomes of cancer and non-cancer patients with acute kidney injury and need of renal replacement therapy admitted to general intensive care units. Nephrol Dial Transplant 26:537–543. doi:10.1093/ndt/gfq441 PubMedCrossRef

34.

McGrath S, Chatterjee F, Whiteley C, Ostermann M (2010) ICU and 6-month outcome of oncology patients in the intensive care unit. QJM 103:397–403. doi:10.1093/qjmed/hcq032 PubMedCrossRef

35.

Mendoza V, Lee A, Marik PE (2008) The hospital-survival and prognostic factors of patients with solid tumors admitted to an ICU. Am J Hosp Palliat Care 25:240–243. doi:10.1177/1049909108315523 PubMedCrossRef

36.

Mokart D, Etienne A, Esterni B, Brun JP, Chow-Chine L, Sannini A, Faucher M, Blache JL (2012) Critically ill cancer patients in the intensive care unit: short-term outcome and 1-year mortality. Acta Anaesthesiol Scand 56:178–189. doi:10.1111/j.1399-6576.2011.02579.x PubMedCrossRef

37.

Mourad M, Chow-Chine L, Faucher M, Sannini A, Brun JP, de Guibert JM, Fouche L, Lambert J, Blache JL, Mokart D (2014) Early diastolic dysfunction is associated with intensive care unit mortality in cancer patients presenting with septic shock. Br J Anaesth 112:102–109. doi:10.1093/Bja/Aet296 PubMedCrossRef

38.

Namendys-Silva SA, Texcocano-Becerra J, Herrera-Gomez A (2010) Prognostic factors in critically ill patients with solid tumours admitted to an oncological intensive care unit. Anaesth Intensive Care 38:317–324PubMed

39.

Namendys-Silva SA, Gonzalez-Herrera MO, Texcocano-Becerra J, Herrera-Gomez A (2011) Clinical characteristics and outcomes of critically ill cancer patients with septic shock. QJM 104:505–511. doi:10.1093/qjmed/hcq260 PubMedCrossRef

40.

Namendys-Silva SA, Gonzalez-Herrera MO, Texcocano-Becerra J, Herrera-Gomez A (2013) Outcomes of critically ill gynecological cancer patients admitted to intensive care unit. Am J Hosp Palliat Medicine 30:7–11. doi:10.1177/1049909112437028 CrossRef

41.

Oeyen SG, Benoit DD, Annemans L, Depuydt PO, Van Belle SJ, Troisi RI, Noens LA, Pattyn P, Decruyenaere JM (2013) Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study. Intensive Care Med 39:889–898. doi:10.1007/s00134-012-2791-x PubMedCrossRef

42.

Okiror L, Patel N, Kho P, Ladas G, Dusmet M, Jordan S, Cordingley J, Lim E (2012) Predicting risk of intensive care unit admission after resection for non-small cell lung cancer: a validation study. Interact Cardiovasc Thorac Surg 14:31–33. doi:10.1093/icvts/ivr060 CrossRef

43.

Park DP, Welch CA, Harrison DA, Palser TR, Cromwell DA, Gao F, Alderson D, Rowan KM, Perkins GD (2009) Outcomes following oesophagectomy in patients with oesophageal cancer: a secondary analysis of the ICNARC case mix programme database. Crit Care 13(Suppl 2):S1. doi:10.1186/cc7868 PubMedCrossRefPubMedCentral

44.

Reichner CA, Thompson JA, O’Brien S, Kuru T, Anderson ED (2006) Outcome and code status of lung cancer patients admitted to the medical ICU. Chest 130:719–723. doi:10.1378/chest.130.3.719 PubMedCrossRef

45.

Roques S, Parrot A, Lavole A, Ancel PY, Gounant V, Djibre M, Fartoukh M (2009) Six-month prognosis of patients with lung cancer admitted to the intensive care unit. Intensive Care Med 35:2044–2050. doi:10.1007/s00134-009-1625-y PubMedCrossRef

46.

Slatore CG, Cecere LM, LeTourneau JL, O’Neil ME, Duckart JP, Wiener RS, Farjah F, Cooke CR (2012) Intensive Care Unit Outcomes Among Patients With Lung Cancer in the Surveillance, Epidemiology, and End Results-Medicare Registry. J Clin Oncol 30:1686–1691. doi:10.1200/Jco.2011.40.0846 PubMedCrossRefPubMedCentral

47.

Soares M, Salluh JI, Ferreira CG, Luiz RR, Spector N, Rocco JR (2005) Impact of two different comorbidity measures on the 6-month mortality of critically ill cancer patients. Intensive Care Med 31:408–415. doi:10.1007/s00134-005-2554-z PubMedCrossRef

48.

Soares M, Salluh JI, Toscano L, Dias FL (2007) Outcomes and prognostic factors in patients with head and neck cancer and severe acute illnesses. Intensive Care Med 33:2009–2013. doi:10.1007/s00134-007-0775-z PubMedCrossRef

49.

Soares M, Darmon M, Salluh JI, Ferreira CG, Thiery G, Schlemmer B, Spector N, Azoulay E (2007) Prognosis of lung cancer patients with life-threatening complications. Chest 131:840–846. doi:10.1378/chest.06-2244 PubMedCrossRef

50.

Soares M, Caruso P, Silva E et al (2010) Characteristics and outcomes of patients with cancer requiring admission to intensive care units: a prospective multicentre study. Crit Care Med 38:9–15. doi:10.1097/CCM.0b013e3181c0349e PubMedCrossRef

51.

Song SW, Lee HS, Kim JH, Kim, Lee JM, Zo JI (2007) Readmission to intensive care unit after initial recovery from major thoracic oncology surgery. Ann Thorac Surg 84:1838–1846. doi:10.1016/j.athoracsur.2007.06.074 (discussion)PubMedCrossRef

52.

Song JU, Suh GY, Chung MP, Kim H, Kwon OJ, Jung CW, Kang WK, Park K, Jeon K (2011) Risk factors to predict outcome in critically ill cancer patients receiving chemotherapy in the intensive care unit. Support Care Cancer 19:491–495. doi:10.1007/s00520-010-0841-x PubMedCrossRef

53.

Song JU, Suh GY, Park HY, Lim SY, Han SG, Kang YR, Kwon OJ, Woo S, Jeon K (2012) Early intervention on the outcomes in critically ill cancer patients admitted to intensive care units. Intensive Care Med 38:1505–1513. doi:10.1007/s00134-012-2594-0 PubMedCrossRef

54.

Souza-Dantas VC, Salluh JI, Soares M (2011) Impact of neutropenia on the outcomes of critically ill patients with cancer: a matched case-control study. Ann Oncol 22:2094–2100. doi:10.1093/annonc/mdq711 PubMedCrossRef

55.

Toffart AC, Minet C, Raynard B, Schwebel C, Hamidfar-Roy R, Diab S, Quetant S, Moro-Sibilot D, Azoulay E, Timsit JF (2011) Use of intensive care in patients with nonresectable lung cancer. Chest 139:101–108. doi:10.1378/chest.09-2863 PubMedCrossRef

56.

Unseld S, Schuepbach RA, Maggiorini M (2013) ICU, hospital and one year mortality of patients suffering from solid or haematological malignancies. Swiss Med Wkly 143:w13741. doi:10.4414/smw.2013.13741 PubMed

57.

Welsch T, Degrate L, Zschabitz S, Hofer S, Werner J, Schmidt J (2011) The need for extended intensive care after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Langenbecks Arch Surg 396:353–362. doi:10.1007/s00423-010-0629-y PubMedCrossRef

58.

Zuber B, Tran TC, Aegerter P, Grimaldi D, Charpentier J, Guidet B, Mira JP, Pene F, Network CU-R (2012) Impact of case volume on survival of septic shock in patients with malignancies. Crit Care Med 40:55–62. doi:10.1097/CCM.0b013e31822d74ba PubMedCrossRef

59.

Soares M, Salluh JI, Carvalho MS, Darmon M, Rocco JR, Spector N (2006) Prognosis of critically ill patients with cancer and acute renal dysfunction. J Clin Oncol 24:4003–4010. doi:10.1200/JCO.2006.05.7869 PubMedCrossRef

60.

Soares M, Salluh JI, Torres VB, Leal JV, Spector N (2008) Short- and long-term outcomes of critically ill patients with cancer and prolonged ICU length of stay. Chest 134:520–526. doi:10.1378/chest.08-0359 PubMedCrossRef

61.

Soares M, Salluh JI, Spector N, Rocco JR (2005) Characteristics and outcomes of cancer patients requiring mechanical ventilatory support for >24 hrs. Crit Care Med 33:520–526PubMedCrossRef

62.

Soares M, Salluh JIF, Toscano L, Dias FL (2007) Outcomes and prognostic factors in patients with head and neck cancer and severe acute illnesses. Intensive Care Med 33:2009–2013. doi:10.1007/s00134-007-0775-z PubMedCrossRef

63.

Curado MP, Edwards B, Shin H, Storm H, Ferlay J, Heanue M, Boyle P (2007) Cancer incidence in five continents, vol IX. IARC Scientific Publications No 160, Lyon

64.

Prin M, Wunsch H (2012) International comparisons of intensive care: informing outcomes and improving standards. Curr Opin Crit Care 18:700–706. doi:10.1097/MCC.0b013e32835914d5 PubMedCrossRefPubMedCentral

Title: Survival in solid cancer patients following intensive care unit admission
Authors: Kathryn Puxty
Philip McLoone
Tara Quasim
John Kinsella
David Morrison
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 10/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-014-3471-9

At a glance: The STEP trials

Springer Medicine

Survival in solid cancer patients following intensive care unit admission

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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