Outcome of patients with solid tumors admitted to intensive care units.

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e18701 Background: Intensive care units (ICU) are increasingly managing cancer patients (pts) with life-threatening disease and treatment-related complications. 5% of cancer pts require ICU admission in the early phase of their disease. We sought to determine the outcome of solid tumor (ST) pts admitted to ICU in two UK cancer centres and investigate factors associated with outcome. Methods: Medical records of ST pts admitted to ICU over a 2-year period, with a minimum of 6 months follow-up, were reviewed. Information on cancer treatment, reason for ICU admission, co-morbidities and outcome, was collected. Elective ICU admissions post-surgery were excluded. Results: 137 pts, median age 56 years (range 16-88) were identified. Common tumor types included GU (28%), sarcoma (19%), lung (18%), colorectal (15%) and breast (12%). The majority of pts (71%) had AJCC stage 4 disease. At the time of ICU admission, 74% of pts were on active treatment (9% radical, 18% adjuvant and 46% palliative), 11% were treatment naïve and 15% were on surveillance or receiving best supportive care. Respiratory failure (20%), sepsis (18%) and renal failure (14%) were the most common reasons for ICU admission. The majority of pts had one (56%) or two (31%) organ failure. Median duration of ICU admission was 3 days (0 to 64 days) and total hospital admission was 19 days (0 to 374 days). 29% of pts died on ICU. Overall, 49% survived to hospital discharge. Median overall survival (OS) from ICU admission was 34 days (0 to 989 days) with 47%, 37% and 21% of pts alive at 30 days, 60 days and 6 months, respectively. OS was influenced by ECOG performance status (PS), treatment intent, tumor type and admission reason, but only PS (p = 0.0003) remained associated with OS on multivariate analysis, with median OS not reached for PS 0, 174 days, 32 days and 19 days for PS 1,2 and ≥3 respectively. Conclusions: The outcome of pts with ST requiring ICU admission is poor with only 49% surviving to hospital discharge. Pre-admission PS has a significant impact on outcome and should be considered by oncologists and intensivists as a selection criterion for ICU admission. Prospective studies are required to validate these findings and investigate additional factors associated with OS, disease-free survival and quality of life.

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