Short- and Long-term Outcomes ofCritically Ill Patients With Cancer andProlonged ICU Length of Stay

ABSTRACT

Background: Data on patients with cancer who have a prolonged length of stay (LOS) in the ICUare scarce. The aim of the present study was to evaluate the characteristics and the outcomes ofcancer patients with life-threatening complications with an ICU stay > 21 days.Methods: A cohort study performed at a 10-bed oncology medical-surgical ICU from May 2000 toDecember 2005. Prolonged ICU LOS was defined as an ICU stay > 21 days.Results: During the period, 1,090 patients were admitted to the ICU and 163 patients (15%) hada prolonged ICU LOS. These patients, however, accounted for 48% (5,828/12,224) of the total ICUbed-days. The hospital and 6-month mortality rates were 50% and 60%, respectively, and similar topatients with ICU LOS < 21 days (51% and 61%, respectively). ICU-acquired events and complicationswere common, and the most frequent were infections (90%), mechanical ventilation (99%), andneed for vasopressors (88%). The number of organ failures, older age, and poor performance statuswere the main outcome predictors. The median long-term follow-up after hospital discharge was 537days (range, 193 to 1,119 days), and 29 patients (18%) were alive.Conclusions: Fifteen percent of critically ill patients with cancer had a prolonged ICU LOS. Shortandlong-term survival rates were reasonable, and the prognosis was better than expected a priori. Inour opinion, the length of ICU admission per se should not be used in the clinical decisions regardingthe continuation of treatment in these patients.