Admission criteria and prognostication in patients with cancer admitted to the intensive care unit.
Critical care for patients with cancer was once considered inappropriate because of a perceived poor prognosis for their long-term survival. Three decades of research has yielded evidence to support the use of critical care resources for many patients with cancer. A methodical approach to triage and evaluation of critically ill patients regardless of baseline medical diagnosis, coupled with an appreciation for the likely prognosis of their current cancer, is most likely to yield the fairest and most accurate appropriation of care. No clinical scoring system has emerged that accurately defines the severity of illness and likelihood for survival in patients with cancer. This article reviews the studies that have attempted to apply mortality prediction scales or scoring systems to these patients. Clinical judgment with incorporation of consensus opinions from the literature should be used to develop admission or restriction criteria for intensive care of patients with cancer.
Shelton
Brenda K
BK
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 401 North Broadway, Weinberg Building #1370, Baltimore, MD 21231, USA. sheltbr@jhmi.edu
D003422:Critical Care / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D009369:Neoplasms / Q000628:therapy*; D010343:Patient Admission; D011379:Prognosis