HAEMATOLOGY/ONCOLOGY ICU OUTCOMES AT THE CANBERRA HOSPITAL: A RETROSPECTIVE COHORT STUDY
Authors: Samuel Mark Reynolds
DOI: 10.5281/zenodo.17404924
Published: October 2024
Abstract
<p><strong><em>Background </em></strong></p> <p><em>Outcomes for haematology/oncology patients have improved, however determining their suitability for ICU admission remains challenging and controversial. </em></p> <p><strong><em>Aim </em></strong></p> <p><em>Examine outcomes of patients admitted to an Australian tertiary hospital Intensive Care Unit </em></p> <p><em>(ICU) and explore potential prognostic factors. </em></p> <p><strong><em>Methods </em></strong></p> <p><em>A retrospective review of patients with haematological and solid tumour malignancies nonelectively admitted to The Canberra Hospital (TCH) ICU, between January 2008 and </em></p> <p><em>December 2012. Patient demographics, cancer details, reasons for ICU admission and APACHE II scores were collected and survival rates calculated and correlated with potential prognostic factors. </em></p> <p><strong><em>Results </em></strong></p> <p><em>Of 205 patients, 113 (55%) had haematological malignancies, and 92 (45%) solid tumours; 58% male, and mean age 60.3 years (SD 13.4). 82% of solid tumour patients had metastatic disease and 55% received palliative chemotherapy. Primary reasons for ICU admission included sepsis (59%), respiratory distress (37%) and hypotension/shock (18%). Mean APACHE II score was 20.1(SD 0.55); mean length of stay in ICU, 4 days (SD 5.2); ICU survival was 76% with 62% and 41% alive at 30-days and 6 months respectively. Overall 1 year survival was 36%. High APACHE II scores and ≥2 organs failing were significant risk factors for 30-day mortality. </em></p> <p><strong><em>Conclusion </em></strong></p> <p><em>Short-term outcomes were similar to contemporary studies from a general tertiary hospital setting and better than historical data. 62% of patients were alive 30 days post-ICU admission, with a significant minority alive at 12 months, confirming some patients achieved worthwhile outcomes. Further research is needed to ensure appropriate patient selection and to explore quality of life post ICU. </em></p>
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