title: Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study.
abstract: OBJECTIVE
  Data concerning long-term outcomes and quality of life (QOL) in critically ill cancer patients are scarce. The aims of this study were to assess long-term outcomes and QOL in critically ill patients with hematological (HM) or solid malignancies (SM) 3 months and 1 year after intensive care unit (ICU) discharge, to compare these with QOL before ICU admission, and to identify prognostic indicators of long-term QOL.
  
  
  METHODS
  During a 1 year prospective observational cohort analysis, consecutive patients with HM or SM admitted to the medical or surgical ICU of a university hospital were screened for inclusion. Cancer data, demographics, co-morbidity, severity of illness, organ failures, and outcomes were collected. The QOL before ICU admission, 3 months, and 1 year after ICU discharge was assessed using standardized questionnaires (EuroQoL-5D, Medical Outcomes Study 36-item Short Form Health Survey). Statistical significance was attained at P < 0.05.
  
  
  RESULTS
  There were 483 patients (85 HM, 398 SM) (64% men) with a median age of 62 years included. Mortality rates of HM compared to SM were, respectively: hospital (34 vs. 13%), 3 months (42 vs. 17%), and 1 year (66 vs. 36%) (P < 0.001). QOL declined at 3 months, but improved at 1 year although it remained under baseline QOL, particularly in HM. Older age (P = 0.007), severe comorbidity (P = 0.035), and HM (P = 0.041) were independently associated with poorer QOL at 1 year.
  
  
  CONCLUSIONS
  Long-term outcomes and QOL were poor, particularly in HM. Long-term expectations should play a larger role during multidisciplinary triage decisions upon referral to the ICU.
authors.affiliation: Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium. sandra.oeyen@ugent.be
authors.forename: S G
authors.initials: SG
authors.lastname: Oeyen
authors.forename: D D
authors.initials: DD
authors.lastname: Benoit
authors.forename: L
authors.initials: L
authors.lastname: Annemans
authors.forename: P O
authors.initials: PO
authors.lastname: Depuydt
authors.forename: S J
authors.initials: SJ
authors.lastname: Van Belle
authors.forename: R I
authors.initials: RI
authors.lastname: Troisi
authors.forename: L A
authors.initials: LA
authors.lastname: Noens
authors.forename: P
authors.initials: P
authors.lastname: Pattyn
authors.forename: J M
authors.initials: JM
authors.lastname: Decruyenaere
mesh_terms: D000367:Age Factors; D016009:Chi-Square Distribution; D015897:Comorbidity; D016638:Critical Illness; D003710:Demography; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014218:Triage