Intensive care for patients with gastric cancers: outcome and survival prognostic factors.

ABSTRACT

BACKGROUND: Admission and management of patients with solid malignancies in intensive care unit (ICU) is a controversial topic. To this day, there is no data published concerning patients with gastric cancers hospitalized in ICU. This single center retrospective study reports the characteristics, outcome and prognostic factors of patients hospitalized in ICU for medical reasons over a period of 10 years. METHODS: We performed a single center retrospective study which reports the characteristics, outcome and prognostic factors of patients hospitalized in ICU for medical reasons over a period of 10 years. RESULTS: Thirty-seven patients were included, among whom 24 (64.9%) had metastatic cancer. The most frequent diagnosis on admission was septic shock (48.6%) and 24 patients (64.9%) required intubation. Ten patients (27.0%) were alive 3 months after their admission in ICU. Metastatic cancer and intubation were independently associated with a higher risk of dying within 3 months of admission in multivariate analysis: odds ratio (OR) =13.7; 95% confidence interval (CI), 1.7-108 (P<0.01). Seventeen patients (45.9%) died during their ICU stay. Metastatic cancer OR =89; 95% CI, 2.7-6,588, therapeutic intensification OR =1,471; 95% CI, 9.8-811,973 and the logistic organ dysfunction score (LODS) on admission OR =1.4; 95% CI, 1.1-2.3 were independently associated with mortality within the ICU in multivariate analysis (P<0.01). CONCLUSIONS: This is the first study that examines the outcome and prognostic factors of patients with gastric cancers who require life-sustaining therapy in ICU. The identification of 3 months and ICU mortality prognostic factors could contribute to guiding clinicians in the management of these patients and assist health professionals in their discussions with these patients and their families.