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[Cancer patients in the intensive care unit].

C Lueck1, G Beutel2

  • 1Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|February 16, 2021
PubMed
Summary

Cancer patients in the intensive care unit (ICU) have improved survival rates, now 50-60%. Early transfer and organ function, not cancer type, determine prognosis for critically ill cancer patients.

Keywords:
ComorbidityMortalityMultiple organ failureNeoplasmsPrognosis

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Area of Science:

  • Oncology
  • Critical Care Medicine
  • Intensive Care Medicine

Background:

  • Increasing prevalence of cancer patients in intensive care units (ICUs) due to demographic shifts and improved life expectancy.
  • Acute organ dysfunction, rather than the primary cancer, is the key determinant of prognosis for these patients.
  • Hematologic cancer patients typically experience more severe disease courses compared to those with solid tumors.

Purpose of the Study:

  • To analyze the prognosis and survival rates of cancer patients admitted to the ICU.
  • To evaluate the impact of transfer timing and organ function on patient outcomes.
  • To reassess the traditional approach to admitting cancer patients to the ICU.

Main Methods:

  • Review of demographic changes and life expectancy trends in cancer patients over 20 years.
  • Analysis of factors influencing prognosis, including organ dysfunction and malignancy type.
  • Comparison of hospital mortality rates between cancer patients and the general population.

Main Results:

  • Early transfer to the ICU is associated with reduced hospital mortality.
  • Multiorgan failure upon ICU admission correlates with increased mortality.
  • Overall intensive care and hospital survival for critically ill hematologic or oncologic patients has risen to 50-60% over two decades.
  • One-fifth of survivors have a good long-term prognosis.

Conclusions:

  • The general exclusion of cancer patients from ICU care is no longer justifiable.
  • Prognosis is primarily dictated by acute organ dysfunction, necessitating timely ICU transfer.
  • Optimal care requires close collaboration between oncologists, hematologists, and intensive care physicians.