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Rate and patterns of ICU admission among colorectal cancer patients: a single-center experience
M F Camus1, L Ameye, T Berghmans
1Service des soins intensifs et urgences oncologiques and oncologie thoracique, Institut Jules Bordet, Université Libre de Bruxelles (ULB), 1, rue Héger Bordet, 1000, Bruxelles, Belgium.
Insights
Colorectal cancer patients admitted to the ICU often experience metabolic or hemodynamic complications. Predictors of death include SOFA score and fever, while cancer stage impacts long-term survival.
Area of Science:
- Oncology
- Critical Care Medicine
- Internal Medicine
Background:
- Colorectal cancer (CRC) patients require intensive care for various complications.
- Understanding ICU admission causes and mortality predictors is crucial for patient outcomes.
Purpose of the Study:
- To determine the reasons for ICU admission in colorectal cancer patients.
- To identify predictors of in-hospital and post-discharge mortality.
Main Methods:
- Retrospective study of colorectal cancer patients admitted to ICU from 2003-2012.
- Analysis of 89 eligible patients to assess causes of admission and mortality predictors.
Main Results:
- Metabolic, hemodynamic, and cardiovascular issues were primary ICU admission causes.
- In-hospital mortality predictors included SOFA score, fever, and GOT levels.
- Cancer control and LDH levels predicted longer-term survival post-discharge.
Conclusions:
- This study highlights specific ICU admission causes for colorectal cancer patients.
- Complication characteristics influenced hospital mortality, while cancer factors affected long-term survival.
Purpose:
The purposes of this study were to evaluate, in colorectal cancer patients, the cause of ICU admission and to find predictors of death during and after hospitalization.
Methods:
This is a retrospective study including all patients with colorectal cancer admitted in the ICU of a cancer hospital from January 1st 2003 to December 31 2012.
Results:
Among 3721 ICU admissions occurring during the study period, 119 (3.2 %) admissions dealt with colorectal cancer, of whom 89 were eligible and assessable. The main reasons for admission were of metabolic (24 %), hemodynamic (19 %), cardiovascular (18 %), gastrointestinal (16 %), respiratory (13 %), or neurologic (6 %) origin. These complications were due to cancer in 43 %, to the antineoplastic treatment in 25 %, or were unrelated to the cancer or its treatment in 33 %. A quarter of the patients died during hospitalization. Independent predictors of death were the Sequential Organ Failure Assessment (SOFA) score (with risk of dying increasing by 42 % per unit of SOFA score), fever (with risk of dying multiplied by three per °C), and high values of GOT (with risk of dying multiplied by 1 % per unit increase), while cancer control (i.e., stage progression or not), compliance to the initial cancer treatment plan, and LDH ≤ median levels had prognostic significance for further longer survival after hospital discharge.
Conclusion:
This is the first study looking at specific causes for unplanned ICU admission of patients with colorectal cancer. Hospital mortality was influenced by the characteristics of the complication that entailed the ICU admission while cancer characteristics retained their prognostic influence on survival after hospital discharge.
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