Influence of malignancy on the decision to withhold or withdraw life-sustaining therapy in critically ill patients.
OBJECTIVE
To evaluate the influence of malignancy on the decision to limit life-sustaining therapy in the intensive care unit (ICU).


METHODS
At the day of patients' admission to the ICU, we prospectively collected information on demographics, acute physiology and chronic health evaluation (APACHE) II score, and features related to malignancy. We retrospectively collected information on in-hospital survival and decision to withhold or withdraw life-sustaining treatment.


RESULTS
This study included 122 adult critically ill patients. After adjusting for age and APACHE II score, patients with malignancy had 3.02 (95% CI 1.19 to 7.62) higher odds of having life-sustaining therapy withdrawn or withheld as compared to patients without active malignancy.


CONCLUSIONS
Our study showed that critically ill patients with malignancy are more likely to have their life-sustaining therapy withheld or withdrawn than those without malignancy after adjusting for severity of disease. This finding may be related to a perception that critically ill patients with malignancy have worse prognosis as compared with those without malignancy.
Cavallazzi
Rodrigo
R
Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, 834 Walnut St, Suite 650, Philadelphia, PA 19107, USA. rcavallazzi@gmail.com
Hirani
Amyn
A
Vasu
Tajender S
TS
Pachinburavan
Monvasi
M
Kane
Gregory C
GC
D018806:APACHE; D016223:Advance Directives; D000367:Age Factors; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011379:Prognosis; D028761:Withholding Treatment