title: Risk of Critical Illness Among Patients With Solid Cancers: A Population-Based Observational Study.
abstract: OBJECTIVE
  Critical illness may be a potential determinant of cancer outcomes and geographic variations, but its role has not been described before.
  
  
  OBJECTIVE
  To determine the incidence of admission to intensive care units (ICUs) within 2 years following cancer diagnosis.
  
  
  METHODS
  This was a retrospective observational study using cancer registry data in 4 datasets from 2000 to 2009 with linked ICU admission data from 2000 to 2011, in the West of Scotland region of the United Kingdom (population, 2.4 million; all 16 ICUs within the region). All 118,541 patients (≥16 years) diagnosed as having solid (nonhematological) cancers. Their median age was 69 years, and 52.0% were women.
  
  
  METHODS
  Demographic and clinical variables associated with admission to an ICU and death in an ICU.
  
  
  RESULTS
  A total of 118,541 patients met the study criteria. Overall, 6116 patients (5.2% [95% CI, 5.0%-5.3%]) developed a critical illness and were admitted to an ICU within 2 years. Risk of critical illness was highest at ages 60 to 69 years and higher in men. The cumulative incidence of critical illness was greatest for small intestinal (17.2% [95% CI, 13.3%-21.8%]) and colorectal cancers (16.5% [95% CI, 15.9%-17.1%]). The risk following breast cancer was low (0.8% [95% CI, 0.7%-1.0%]). The percentage who died in ICUs was 14.1% (95% CI, 13.3%-15.0%), and during the hospital stay, 24.6% (95% CI, 23.5%-25.7%). Mortality was greatest among emergency medical admissions and lowest among elective surgical patients. The risk of critical illness did not vary by socioeconomic circumstances, but mortality was higher among patients from deprived areas.
  
  
  CONCLUSIONS
  In this study, about 1 in 20 patients experienced a critical illness resulting in ICU admission within 2 years of cancer diagnosis. The associated high mortality rate may make a significant contribution to overall cancer outcomes.
authors: Anaesthesia and Intensive Care, School of Medicine, Glasgow Royal Infirmary, Glasgow, Scotland.
authors: Kathryn
authors: K
authors: Puxty
authors: West of Scotland Cancer Surveillance Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
authors: Philip
authors: P
authors: McLoone
authors: Anaesthesia and Intensive Care, School of Medicine, Glasgow Royal Infirmary, Glasgow, Scotland.
authors: Tara
authors: T
authors: Quasim
authors: West of Scotland Cancer Surveillance Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
authors: Billy
authors: B
authors: Sloan
authors: Anaesthesia and Intensive Care, School of Medicine, Glasgow Royal Infirmary, Glasgow, Scotland.
authors: John
authors: J
authors: Kinsella
authors: West of Scotland Cancer Surveillance Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
authors: David S
authors: DS
authors: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006742:Hospital Bed Capacity; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D010343:Patient Admission; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult