title: Characteristics and outcomes of patients with cancer requiring admission to intensive care units: a prospective multicenter study.
abstract: OBJECTIVE
  To evaluate the characteristics and outcomes of patients with cancer admitted to several intensive care units. Knowledge on patients with cancer requiring intensive care is mostly restricted to single-center studies.
  
  
  METHODS
  : Prospective, multicenter, cohort study.
  
  
  METHODS
  Intensive care units from 28 hospitals in Brazil.
  
  
  METHODS
  A total of 717 consecutive patients included over a 2-mo period.
  
  
  METHODS
  None.
  
  
  RESULTS
  There were 667 (93%) patients with solid tumors and 50 (7%) patients had hematologic malignancies. The main reasons for intensive care unit admission were postoperative care (57%), sepsis (15%), and respiratory failure (10%). Overall hospital mortality rate was 30% and was higher in patients admitted because of medical complications (58%) than in emergency (37%) and scheduled (11%) surgical patients (p < .001). Adjusting for covariates other than the type of admission, the number of hospital days before intensive care unit admission (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.01-1.37), higher Sequential Organ Failure Assessment scores (OR, 1.25; 95% CI, 1.17-1.34), poor performance status (OR, 3.40; 95% CI, 2.19 -5.26), the need for mechanical ventilation (OR, 2.42; 95% CI, 1.51-3.87), and active underlying malignancy in recurrence or progression (OR, 2.42; 95% CI, 1.51-3.87) were associated with increased hospital mortality in multivariate analysis.
  
  
  CONCLUSIONS
  This large multicenter study reports encouraging survival rates for patients with cancer requiring intensive care. In these patients, mortality was mostly dependent on the severity of organ failures, performance status, and need for mechanical ventilation rather than cancer-related characteristics, such as the type of malignancy or the presence of neutropenia.
authors.affiliation: ICU, Hospital de Câncer - I, Instituto Nacional de Câncer, Rio de Janeiro, Brazil. marciosoaresms@yahoo.com.br
authors.forename: Márcio
authors.initials: M
authors.lastname: Soares
authors.forename: Pedro
authors.initials: P
authors.lastname: Caruso
authors.forename: Eliézer
authors.initials: E
authors.lastname: Silva
authors.forename: José M M
authors.initials: JM
authors.lastname: Teles
authors.forename: Suzana M A
authors.initials: SM
authors.lastname: Lobo
authors.forename: Gilberto
authors.initials: G
authors.lastname: Friedman
authors.forename: Felipe
authors.initials: F
authors.lastname: Dal Pizzol
authors.forename: Patricia V C
authors.initials: PV
authors.lastname: Mello
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Bozza
authors.forename: Ulisses V A
authors.initials: UV
authors.lastname: Silva
authors.forename: André P
authors.initials: AP
authors.lastname: Torelly
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Knibel
authors.forename: Ederlon
authors.initials: E
authors.lastname: Rezende
authors.forename: José J
authors.initials: JJ
authors.lastname: Netto
authors.forename: Claudio
authors.initials: C
authors.lastname: Piras
authors.forename: Aline
authors.initials: A
authors.lastname: Castro
authors.forename: Bruno S
authors.initials: BS
authors.lastname: Ferreira
authors.forename: Alvaro
authors.initials: A
authors.lastname: Réa-Neto
authors.forename: Patrícia B
authors.initials: PB
authors.lastname: Olmedo
authors.forename: Jorge I F
authors.initials: JI
authors.lastname: Salluh
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001938:Brazil; D015331:Cohort Studies; D016001:Confidence Intervals; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data*; D011336:Probability; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult