Acute Crit Care.  2018 Aug;33(3):121-129. 10.4266/acc.2018.00143.

Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units

• Na SJ
• Ha TS
• Koh Y
• Suh GY
• Koh SO
• Lim CM
• Choi WI
• Lee YJ
• Kim SC
• Chon GR
• Kim JH
• Kim JY
• Lim J
• Park S
• Kim HC
• Lee JH
• Lee JH
• Park J
• Cho J
• Jeon K
• Validation of Simplified Acute Physiology Score 3 in Korean Intensive care unit (VSKI) study group
• Korean Study Group On Respiratory Failure (KOSREF)

• KMID: 2436323
• DOI: http://doi.org/10.4266/acc.2018.00143

Abstract

BACKGROUND
The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
METHODS
This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
RESULTS
During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P < 0.001) and SAPS3 (71 vs. 69, P < 0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P < 0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
CONCLUSIONS
Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.

Keyword

cancer; critical care; epidemiology; hematologic neoplasm; mortality

MeSH Terms

Cohort Studies
Critical Care*
Critical Illness*
Drug Therapy
Epidemiology
Hematologic Neoplasms
Humans
Intensive Care Units*
Korea
Mortality
Physiology
Prognosis
Prospective Studies
Renal Replacement Therapy
Respiration, Artificial
Retrospective Studies

Figure

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  Figure 1. A schematic of study participant flow. ICU: intensive care unit.

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  Figure 2. A comparison of intensive care unit (ICU) and hospital mortality.

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