title: Short-term and medium-term survival of critically ill patients with solid tumours admitted to the intensive care unit: a retrospective analysis.
abstract: Patients with cancer frequently require unplanned admission to the intensive care unit (ICU). Our objectives were to assess hospital and 180-day mortality in patients with a non-haematological malignancy and unplanned ICU admission and to identify which factors present on admission were the best predictors of mortality.
  
  
  
  Retrospective review of all patients with a diagnosis of solid tumours following unplanned admission to the ICU between 1 August 2008 and 31 July 2012.
  
  
  
  Single centre tertiary care hospital in London (UK).
  
  
  
  300 adult patients with non-haematological solid tumours requiring unplanned admission to the ICU.
  
  
  
  None.
  
  
  
  Hospital and 180-day survival.
  
  
  
  300 patients were admitted to the ICU (median age 66.5 years; 61.7% men). Survival to hospital discharge and 180 days were 69% and 47.8%, respectively. Greater number of failed organ systems on admission was associated with significantly worse hospital survival (p<0.001) but not with 180-day survival (p=0.24). In multivariate analysis, predictors of hospital mortality were the presence of metastases (OR 1.97, 95% CI 1.08 to 3.59), Acute Physiology and Chronic Health Evaluation II (APACHE II) Score (OR 1.07, 95% CI 1.01 to 1.13) and a Glasgow Coma Scale Score <7 on admission to ICU (OR 5.21, 95% CI 1.65 to 16.43). Predictors of worse 180-day survival were the presence of metastases (OR 2.82, 95% CI 1.57 to 5.06), APACHE II Score (OR 1.07, 95% CI 1.01 to 1.13) and sepsis (OR 1.92, 95% CI 1.09 to 3.38).
  
  
  
  Short-term and medium-term survival in patients with solid tumours admitted to ICU is better than previously reported, suggesting that the presence of cancer alone should not be a barrier to ICU admission.
authors: Department of Critical Care, King's College London, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.|Department of Critical Care, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors: Richard
authors: R
authors: Fisher
authors: Department of Critical Care, King's College London, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.|Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
authors: Carole
authors: C
authors: Dangoisse
authors: Division of Health and Social Care Research, King's College London, London, UK.
authors: Siobhan
authors: S
authors: Crichton
authors: Department of Critical Care, King's College London, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: Craig
authors: C
authors: Whiteley
authors: Department of Critical Care, King's College London, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: Luigi
authors: L
authors: Camporota
authors: Department of Critical Care, King's College London, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: Richard
authors: R
authors: Beale
authors: Department of Critical Care, King's College London, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: Marlies
authors: M
authors: Ostermann
mesh_terms: D018806:APACHE; D000368:Aged; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D016019:Survival Analysis