title: Outcomes of cancer patients after unplanned admission to general intensive care units.
abstract: BACKGROUND
  Acute admission to an intensive care unit (ICU) of cancer patients is considered with increasing frequency due to a better life expectancy and more aggressive therapies. The aim of this study was to determine the characteristics and outcomes of cancer patients with unplanned admissions to general ICUs, and to compare these with outcomes of critically ill patients without cancer.
  
  
  METHODS
  All unplanned ICU admissions in the Netherlands collected in the National Intensive Care Evaluation registry between January 2007 and January 2011 were analyzed.
  
  
  CONCLUSIONS
  Of the 140,154 patients with unplanned ICU admission 10.9% had a malignancy. Medical cancer patients were more severely ill on ICU admission in comparison with medical non-cancer patients, as reflected by higher needs for mechanical ventilation (50.8% vs. 46.4%, p < 0.001) and vasopressors within 24 hours after admission (41.5% vs. 33.0%, p < 0.001), higher Acute Physiology and Chronic Health Evaluation (APACHE) IV scores (88.1 vs. 67.5, p < 0.001) and a longer ICU stay (5.1 vs. 4.6 days, p < 0.001). In contrast, surgical cancer patients only displayed a modestly higher APACHE IV score on admission when compared with non-cancer surgical patients, whereas the other afore mentioned parameters were lower in the surgical cancer patients group. In-hospital mortality was almost twice as high in medical cancer patients (40.6%) as in medical patients without cancer (23.7%). In-hospital mortality of surgical cancer patients (17.4%) was slightly higher than in patients without cancer (14.6%). These data indicate that unplanned ICU admission is associated with a high mortality in patients with cancer when admitted for medical reasons.
authors.affiliation: Reinier de Graaf Hospital, Department of Internal Medicine, Division of Medical Oncology Delft, the Netherlands. bos@rdgg.nl
authors.forename: Monique M E M
authors.initials: MM
authors.lastname: Bos
authors.forename: Nicolette F
authors.initials: NF
authors.lastname: de Keizer
authors.forename: Iwan A
authors.initials: IA
authors.lastname: Meynaar
authors.forename: Ferishta
authors.initials: F
authors.lastname: Bakhshi-Raiez
authors.forename: Evert
authors.initials: E
authors.lastname: de Jonge
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D005260:Female; D019538:Health Care Surveys; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D012042:Registries; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D014662:Vasoconstrictor Agents