Outcomes of critically ill cancer patients in a university hospital setting

Critically ill cancer patients constitute a large percentage of admissions to tertiary care medical intensive care units (ICUs). We sought to describe outcomes of such patients, and to evaluate how conditions commonly seen in these patients impact mortality. A total of 348 consecutive medical ICU ca ncer patients were evaluated. Subgroup comparisons included the three most common cancer types (leukemia, lymphoma, lung cancer), as well as three dif ferent treatments/conditions (bone marrow transplant [BMT] versus non-BMT m echanical ventilation [MV] versus non-MV, neutropenic versus non-neutropeni c). There were no mortality differences between patients with leukemia, lym phoma, or lung cancer. By logistic regression, mortality predictors were: M V, hepatic failure, and cardiovascular failure for the group as a whole (41 % overall mortality); MV and allogeneic las compared with autologous) BMT f or the BMT group (39% overall mortality); hepatic failure, cardiovascular f ailure, and persistent acute respiratory distress syndrome (ARDS) for the M V group (67% overall mortality); and MV for the neutropenic group (53% over all mortality). Neutropenia showed no independent association with mortalit y in the group as a whole or any subgroup analyzed. We conclude that respir atory, hepatic, and cardiovascular failure predict mortality, whereas neutr openia does not. Additionally, we have noted an encouraging improvement in survival in many groups of critically ill cancer patients.