An analysis of patients transferred to a tertiary oncological intensive care unit for defined procedures.
BACKGROUND
Up to 50 000 intensive care unit interhospital transfers occur annually in the United States.


OBJECTIVE
To determine the prevalence, characteristics, and outcomes of cancer patients transferred from an intensive care unit in one hospital to another intensive care unit at an oncological center and to evaluate whether interventions planned before transfer were performed.


METHODS
Data on transfers for planned interventions from January 2008 through December 2012 were identified retrospectively. Demographic and clinical variables, receipt of planned interventions, and outcome data were analyzed.


RESULTS
Of 4625 admissions to an intensive care unit at the oncological center, 143 (3%) were transfers from intensive care units of other hospitals. Of these, 47 (33%) were transfers for planned interventions. Patients' mean age was 57 years, and 68% were men. At the time of intensive care unit transfer, 20 (43%) were receiving mechanical ventilation. Interventions included management of airway (n = 19) or gastrointestinal (n = 2) obstruction, treatment of tumor bleeding (n = 12), chemotherapy (n = 10), and other (n = 4). A total of 37 patients (79%) received the planned interventions within 48 hours of intensive care unit arrival; 10 (21%) did not because their signs and symptoms abated. Median intensive care unit and hospital lengths of stay at the oncological center were 4 and 13 days, respectively. Intensive care unit and hospital mortality rates were 11% and 19%, respectively. Deaths occurred only in patients who received interventions.


CONCLUSIONS
Interhospital transfers of cancer patients to an intensive care unit at an oncological center are infrequent but are most commonly done for direct interventional care. Most patients received planned interventions soon after transfer.
At the time of this study Sunil Kamat and Prabalini Rajendram were fellows, Sanjay Chawla is an assistant attending physician, Stephen M. Pastores is the critical care fellowship program director, Natalie Kostelecky is a research nurse, and Neil A. Halpern is the chief, Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Sunil
S
Kamat
At the time of this study Sunil Kamat and Prabalini Rajendram were fellows, Sanjay Chawla is an assistant attending physician, Stephen M. Pastores is the critical care fellowship program director, Natalie Kostelecky is a research nurse, and Neil A. Halpern is the chief, Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. chawlas@mskcc.org.
Sanjay
S
Chawla
At the time of this study Sunil Kamat and Prabalini Rajendram were fellows, Sanjay Chawla is an assistant attending physician, Stephen M. Pastores is the critical care fellowship program director, Natalie Kostelecky is a research nurse, and Neil A. Halpern is the chief, Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Prabalini
P
Rajendram
At the time of this study Sunil Kamat and Prabalini Rajendram were fellows, Sanjay Chawla is an assistant attending physician, Stephen M. Pastores is the critical care fellowship program director, Natalie Kostelecky is a research nurse, and Neil A. Halpern is the chief, Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Stephen M
SM
Pastores
At the time of this study Sunil Kamat and Prabalini Rajendram were fellows, Sanjay Chawla is an assistant attending physician, Stephen M. Pastores is the critical care fellowship program director, Natalie Kostelecky is a research nurse, and Neil A. Halpern is the chief, Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Natalie
N
Kostelecky
At the time of this study Sunil Kamat and Prabalini Rajendram were fellows, Sanjay Chawla is an assistant attending physician, Stephen M. Pastores is the critical care fellowship program director, Natalie Kostelecky is a research nurse, and Neil A. Halpern is the chief, Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Neil A
NA
Halpern
D058109:Airway Management; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007415:Intestinal Obstruction; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*