Mortality of Adult Patients With Cancer Admitted to an Intensive Care Unit in Chile: A Prospective Cohort Study

Sergio Panay, Carolina Ruiz, Marcelo Abarca, Bruno Nervi, Ignacio Salazar, Paulo Caro, Sabrina Muñiz, Juan Briones, Alejandro Bruhn, Sebastian Mondaca, Sergio Panay, Carolina Ruiz, Marcelo Abarca, Bruno Nervi, Ignacio Salazar, Paulo Caro, Sabrina Muñiz, Juan Briones, Alejandro Bruhn, Sebastian Mondaca

Abstract

Purpose: Increasing numbers of reports have shown acceptable short-term mortality of patients with cancer admitted into the intensive care unit (ICU). The aim of this study was to determine the mortality of critically ill patients with cancer admitted to the ICU in a general hospital in Chile.

Materials and methods: This was a prospective cohort trial in which we included all patients with cancer admitted to the ICU between July 2015 and September 2016. Demographic, physiologic, and treatment data were registered, and survival at 30 days and 6 months was evaluated. A prespecified subgroup analysis considering the admission policy was performed. These subgroups were (1) ICU admission for full code management and (2) ICU trial (IT).

Results: During the study period, 109 patients with cancer were included. Seventy-nine patients were considered in the full code management group and 30 in the IT. The mean age of patients was 60 years (standard deviation [SD], 15), and 56% were male. Lymphoma was the most frequent malignancy (17%), and 59% had not received cancer treatment because of a recent diagnosis. The mean Acute Physiology and Chronic Health Evaluation and Sequential-Related Organ Failure Assessment scores were 22.2 (SD, 7.3) and 7 (SD, 3), respectively. There were no differences in vasopressor, fluid, or transfusion requirements between subgroups. Lactate levels, Sequential-Related Organ Failure Assessment scores (day 1, 3, and 5), complications, and ICU length of stay were similar. In the entire cohort, 30-day and 6-month mortality was 47% and 66%, respectively. There was no difference in mortality between subgroups according to the admission policy.

Conclusion: Patients admitted to the ICU in a developing country are at high risk for short-term mortality. However, there is a relevant subgroup that achieves 6-month survival, even among patients who undergo an IT.

Trial registration: ClinicalTrials.gov NCT02659839.

Conflict of interest statement

Sergio Panay

Travel, Accommodations, Expenses: Roche

Carolina Ruiz

No relationship to disclose

Marcelo Abarca

No relationship to disclose

Bruno Nervi

No relationship to disclose

Ignacio Salazar

No relationship to disclose

Paulo Caro

No relationship to disclose

Sabrina Muñiz

No relationship to disclose

Juan Briones

No relationship to disclose

Alejandro Bruhn

No relationship to disclose

Sebastian Mondaca

Travel, Accommodations, Expenses: Roche

Figures

Fig 1
Fig 1
Flow diagram of the study. ICU, intensive care unit; FCM, full code management.

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