Background: Recent data suggest that the outcome of patients with solid tumours admitted to ICU/HDU is similar to non-cancer patients. However, there remains a perception in clinical practice that intensive care units are reluctant to accept medical oncology patients. The aim of our study was to compare the length of ICU/HDU stay and short term outcomes of medical oncology patients versus non-cancer patients.
Methods: Data was retrospectively collected from medical case notes, RPH Cancer Registry and electronic patients’ records between 8th Feb 2010 and 30th May 2014. All medical oncology patients admitted to ICU/HDU during this period were included. A separate cohort of non-cancer patients from different medical specialties admitted to ICU/HDU between 1st Jan 2014 and 30th May 2014 was used as the control arm.
Results: 58 medical oncology patients and 100 non-cancer patients were identified. The median age of both groups was 61years. The median length of ICU/HDU stay was 2.1 vs. 2.6 days for cancer and non-cancer patients respectively. Common tumor types included: head & neck 20%, breast cancer 15%, oesophageal 11% & lung cancer 11%. Common reasons for admissions were septic shock (22%) respiratory failure (22%) and post surgery (13%). Interventions at ICU/HDA included inotropic support (18%), non-invasive ventilation (18%) and mechanical ventilation (13%). Mean APACHEII score for the patients with a malignancy was 17. The 30-day mortality rates were 30% for the cancer patients and 35% non-cancer patients. For the cancer group, the 3 month survival rate was 53% and the 6 month survival rate was 34%.
Conclusion: The similar length of stay and short term outcomes of medical oncology patients and non-cancer patients admitted to ICU/HDU in our study support their admission to ICU/HDU during an acute illness.