Mortality of Adult Critically Ill Subjects With Cancer

• Published in: Respiratory care Vol. 62; no. 5; pp. 615 - 622
• Main Authors: Rosa, Regis Goulart, Tonietto, Tulio Frederico, Duso, Bruno Achutti, Maccari, Juçara Gasparetto, de Oliveira, Roselaine Pinheiro, Rutzen, William, Madeira, Laura, Ascoli, Aline, Hessler, Rachel, Morandi, Paola, Cremonese, Ricardo Viegas, Neto, Felippe Leopoldo Dexheimer, Tagliari, Luciana, de Campos Balzano, Patrícia, Barth, José Hervê Diel, Teixeira, Cassiano
• Format: Journal Article
• Language: English
• Published: United States Daedalus Enterprises, Inc 01-05-2017
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Brazil; Brazil - epidemiology; Cancer patients; Care and treatment; Cause of Death; Control; Critical Illness - mortality; Databases, Factual; Female; Hospital Mortality; Humans; Influence; Intensive care units; Intensive Care Units - statistics & numerical data; Longitudinal Studies; Male; Medical examination; Middle Aged; Mortality; Neoplasms - mortality; Propensity Score; Retrospective Studies; Survival Analysis; Brazil; critical care; mortality; cancer; critical illness; prognosis
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.05210

Cancer patients may require intensive care support for postoperative care, complications associated with underlying malignancy, or toxicities related to cancer therapy. The higher mortality rates found in this population than in the population of ICU patients without cancer may be attributable to confounding due to a higher prevalence of multiple organic dysfunctions at ICU admission in patients with malignancy; however, data regarding this hypothesis are scarce. Accordingly, we performed the present study to compare the crude and propensity score-matched mortality rates between adult subjects with and without cancer admitted to a mixed medical-surgical ICU.
We conducted a retrospective analysis of a comprehensive longitudinal ICU database in a tertiary referral hospital in Southern Brazil. All adult subjects who were admitted to the ICU from January 2008 to December 2014 were evaluated. Crude and propensity score-matched all-cause 30-d mortality rates of critically ill subjects with cancer were compared with those of critically ill subjects without cancer.
A total of 4,221 subjects were evaluated. The survival analysis revealed that the crude mortality rate was higher among subjects with cancer than among subjects without cancer (18.7% vs 10.2%,
< .001). However, after matching by propensity score, the 30-d mortality rates of subjects with and without cancer were similar (18.5% vs 15.2%,
= .17).
The present study failed to show an association between malignancy and all-cause 30-d mortality rate in adult subjects admitted to a mixed medical-surgical ICU. The propensity score-matched analysis showed no evidence of excessive mortality due to cancer diagnosis.