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Initial Outcomes No Worse for Surgical ICU Patients With CA

FRIDAY, June 29, 2018 -- Surgical patients who are admitted to the intensive care unit (ICU) and have cancer do not have worse initial outcomes than those without cancer, according to a study published online June 27 in JAMA Surgery.

Kathryn Puxty, M.B.Ch.B., M.D., from Glasgow Royal Infirmary in the United Kingdom, and colleagues conducted an observational retrospective cohort study using ICU audit records linked to hospitalization discharge summaries, cancer registrations, and death records of 16 ICUs. Data were included for 25,017 surgical ICU admissions between Jan. 1, 2000, and Dec. 31, 2011.

The researchers found that 21.8 percent of the surgical ICU patients had an underlying solid tumor diagnosis. The cancer group had lower ICU and hospital mortality than the noncancer group, at 12.2 versus 16.8 percent and 22.9 versus 28.1 percent (both P < 0.001). The adjusted odds ratio for hospital mortality was 1.09 (95 percent confidence interval, 1 to 1.19) for patients with cancer. By six months, mortality was higher in the cancer versus the noncancer group (31.3 versus 28.2 percent; P < 0.001). For those with and without cancer, mortality was 60.9 versus 39.7 percent four years after ICU admission (P < 0.001).

"Cancer is a common diagnosis among surgical ICU patients and this study suggests that initial outcomes compare favorably with those of ICU patients with other conditions," the authors write. "Consideration that a diagnosis of cancer should not preclude admission to the ICU in patients with surgical disease is suggested."

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Posted: June 2018

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