Age and utilization of intensive care unit resources of critically ill cancer patients

Older patients, patients with malignancies, and those admitted to ICUs utilize a disproportionate amount of hospital resources. To evaluate the combined impact of age and a diagnosis of malignancy on ICU utilization and outcome, we reviewed the care provided to all 1,212 patients admitted to a medical/surgical ICU in a hospital specializing in the treatment of cancer between January 1, 1986 and December 31, 1987. Patients between 19 and 64 yr (young) were compared with those between 65 and 74 yr (young-old) and with those greater than or equal to 75 yr (old-old) with respect to utilization of nutritional support (total parenteral nutrition [TPN]), mechanical ventilation (MV), pulmonary artery (PA) catheterization, dialysis (D), and blood products (B). Mean length of stay (LOS) in the ICU, primary diagnosis, outcome, and average daily severity of illness scores (ADTIS) were also compared. Old-old patients represented 14% of all ICU patients and young-old patients represented 28%; 64% of old-old and 61% of young-old patients had solid tumors, compared with 36% of younger patients. The ICU mortality of the two older groups was significantly lower than that of the younger patients (17%, 27%, and 30%, respectively). The use of TPN, PA catheters, and D was similar for all three groups, but older patients used less MV and B than the younger patients (p less than .0001, chi2 analysis). The two older groups also had similar LOS and lower average daily Therapeutic Intervention Scoring Systems (TISS) scores than their younger cohort.(ABSTRACT TRUNCATED AT 250 WORDS)