Retrospective Analysis of Outcome of Women with Breast or Gynaecological Cancer in the Intensive Care Unit

Overview

Journal JRSM Short Rep

Specialty General Medicine

Date 2013 Feb 16

PMID 23413404

Citations 6

Authors

Marlies Ostermann

Mario Raimundo

Anna Williams

Craig Whiteley

Richard Beale

Affiliations

Soon will be listed here.

Abstract

Objectives: Advances in oncological care have led to improved short and long-term outcomes of female patients with breast and gynecological cancer but little is known about their prognosis when admitted to the intensive care unit (ICU). Our aim was to describe the epidemiology of patients with women's cancer in ICU.

Design: Retrospective analysis of data of patients with breast and gynecological cancer in ICU between February 2004 and July 2008.

Setting: ICU in a tertiary referral centre in London.

Participants: Nineteen critically ill women with breast or gynaecological cancer.

Main Outcome Measures: ICU and six-month outcome.

Results: Eleven women had breast cancer and eight patients had gynaecological cancer. Twelve patients were known to have metastatic disease. The main reasons for admission to ICU were sepsis (94.7%), respiratory failure (36.8%) and need for vasoactive support (26.3%). ICU mortality was 31.6%. There was no difference in age and Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) score on admission to ICU between ICU survivors and non-survivors. During their stay in ICU, non-survivors had significantly more organ failure. Six-month mortality was 68.4%. Four patients had >1 admission to ICU.

Conclusions: ICU outcome of critically ill women with breast or gynaecological cancer was similar to that of other non-cancer patient cohorts but six-month mortality was significantly higher. The decision to admit patients with women's cancer to the ICU should depend on the severity of the acute illness rather than factors related to the underlying malignancy. More research is needed to explore the outcome of patients with women's cancer after discharge from ICU.

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References

Soares M, Salluh J, Torres V, Leal J, Spector N . Short- and long-term outcomes of critically ill patients with cancer and prolonged ICU length of stay. Chest. 2008; 134(3):520-526. DOI: 10.1378/chest.08-0359. View

Kress J, Christenson J, Pohlman A, Linkin D, Hall J . Outcomes of critically ill cancer patients in a university hospital setting. Am J Respir Crit Care Med. 1999; 160(6):1957-61. DOI: 10.1164/ajrccm.160.6.9812055. View

Winters B, Eberlein M, Leung J, Needham D, Pronovost P, Sevransky J . Long-term mortality and quality of life in sepsis: a systematic review. Crit Care Med. 2010; 38(5):1276-83. DOI: 10.1097/CCM.0b013e3181d8cc1d. View

Vandijck D, Benoit D, Depuydt P, Offner F, Blot S, Van Tilborgh A . Impact of recent intravenous chemotherapy on outcome in severe sepsis and septic shock patients with hematological malignancies. Intensive Care Med. 2008; 34(5):847-55. DOI: 10.1007/s00134-008-1002-2. View

Sculier J, Paesmans M, Markiewicz E, Berghmans T . Scoring systems in cancer patients admitted for an acute complication in a medical intensive care unit. Crit Care Med. 2000; 28(8):2786-92. DOI: 10.1097/00003246-200008000-00018. View

Knaus W, Draper E, Wagner D, Zimmerman J . Prognosis in acute organ-system failure. Ann Surg. 1985; 202(6):685-93. PMC: 1250999. DOI: 10.1097/00000658-198512000-00004. View

Gordon A, Oakervee H, Kaya B, Thomas J, Barnett M, Rohatiner A . Incidence and outcome of critical illness amongst hospitalised patients with haematological malignancy: a prospective observational study of ward and intensive care unit based care. Anaesthesia. 2005; 60(4):340-7. DOI: 10.1111/j.1365-2044.2005.04139.x. View

Geerse D, Span L, Pinto-Sietsma S, van Mook W . Prognosis of patients with haematological malignancies admitted to the intensive care unit: Sequential Organ Failure Assessment (SOFA) trend is a powerful predictor of mortality. Eur J Intern Med. 2011; 22(1):57-61. DOI: 10.1016/j.ejim.2010.11.003. View

Pene F, Percheron S, Lemiale V, Viallon V, Claessens Y, Marque S . Temporal changes in management and outcome of septic shock in patients with malignancies in the intensive care unit. Crit Care Med. 2008; 36(3):690-6. DOI: 10.1097/CCM.0B013E318165314B. View

10.

Kew A, Couban S, Patrick W, Thompson K, White D . Outcome of hematopoietic stem cell transplant recipients admitted to the intensive care unit. Biol Blood Marrow Transplant. 2006; 12(3):301-5. DOI: 10.1016/j.bbmt.2005.10.020. View

11.

Bajwa S, Bajwa S, Kaur J . Care of Terminally ill Cancer Patients: An Intensivist's Dilemma. Indian J Palliat Care. 2011; 16(3):183. PMC: 3012244. DOI: 10.4103/0973-1075.73671. View

12.

Hampshire P, Welch C, McCrossan L, Francis K, Harrison D . Admission factors associated with hospital mortality in patients with haematological malignancy admitted to UK adult, general critical care units: a secondary analysis of the ICNARC Case Mix Programme Database. Crit Care. 2009; 13(4):R137. PMC: 2750195. DOI: 10.1186/cc8016. View

13.

McGrath S, Chatterjee F, Whiteley C, Ostermann M . ICU and 6-month outcome of oncology patients in the intensive care unit. QJM. 2010; 103(6):397-403. DOI: 10.1093/qjmed/hcq032. View

14.

Moran J, Solomon P, Williams P . Assessment of outcome over a 10-year period of patients admitted to a multidisciplinary adult intensive care unit with haematological and solid tumours. Anaesth Intensive Care. 2005; 33(1):26-35. DOI: 10.1177/0310057X0503300105. View

15.

Friedman G, Silva E, Vincent J . Has the mortality of septic shock changed with time. Crit Care Med. 1999; 26(12):2078-86. DOI: 10.1097/00003246-199812000-00045. View

16.

Van Le L, Fakhry S, Walton L, Moore D, Fowler W, Rutledge R . Use of the APACHE II scoring system to determine mortality of gynecologic oncology patients in the intensive care unit. Obstet Gynecol. 1995; 85(1):53-6. DOI: 10.1016/0029-7844(94)00308-z. View

17.

Darmon M, Azoulay E . Critical care management of cancer patients: cause for optimism and need for objectivity. Curr Opin Oncol. 2009; 21(4):318-26. DOI: 10.1097/CCO.0b013e32832b68b6. View

18.

Angus D, Wax R . Epidemiology of sepsis: an update. Crit Care Med. 2001; 29(7 Suppl):S109-16. DOI: 10.1097/00003246-200107001-00035. View

19.

Staudinger T, Stoiser B, Mullner M, Locker G, Laczika K, Knapp S . Outcome and prognostic factors in critically ill cancer patients admitted to the intensive care unit. Crit Care Med. 2000; 28(5):1322-8. DOI: 10.1097/00003246-200005000-00011. View

20.

Ewer M, Ali M, Atta M, Morice R, Balakrishnan P . Outcome of lung cancer patients requiring mechanical ventilation for pulmonary failure. JAMA. 1986; 256(24):3364-6. View