Evaluation of the factors effecting the prognosis of patients with solid tumor and hematologic malignency in intensive care unit

Purpose:Cancer has an increasing incidence worlwide and has a high mortality rate. Patients diagnosed with cancer need to be admitted to intensive care units for various reasons. As a result of the shortage of beds in intensive care units, physicians feel reluctant about the admission of these patients to intensive care units. This study aimed to show the prognostic factors of the patients with solid tumor and hematologic malignancy in intensive care units, and hence guide physicians to manage patients with cancer and their intensive care units. Materials and method: This study included patients who stayed in Dokuz Eylul University Hospital Internal Medicine Intensive Care Unit for more than 24 hours during the January 2012-December 2013 interval. The patients were divided into three groups; patients with solid tumor, patients with hematologic malignancy, and patiens without cancer. Their data was analyzed retrospectively. All patients data (demographic data, organ failure, comorbid diseases, critical diseases, presence of infection, immunsupressive treatments within the last month) were recorded at the time of admittance. In addition to that, presence of remission, history of bone marrow transplantation, previous treatments, presence of neutropenia of patients with solid tumor and hematologic malignancy were also recorded. SPSS 22.0 programe was used to analyse the collected data. Results:Mortality rate in intensive care unit was found to be %46.0 in general, %68.6 in patients with solid tumor, %53.0 in patients with hematologic malignancy, and %39.8 in the control group (n=512; solid tumor=89, hematologic malignancy=49, control group=374). The mortality rate was especially high among patients with solid tumor. In the logistic regression model, APACHE II score and the need of invasive mechanical ventilation at the time of admission to intensive care unit were found as independent risk factors for increased mortality. In addition, the need of renal replacement therapy at the time of admission to intensive care unit was found as an indpendent risk factor for increased mortality among the control group. Conclusion:The mortality rate of patients in intensive care units is high, especially those with solid tumor. At the time of admission to the intensive care unit, for cancer patients with critical illness, the APACHE II score and the need of invasive mechanical ventilation should be evaluated, for these are strong predictors of increased mortality. Keywords:Cancer, Intensive Care Unit, Invasive Mechanical Ventilation, APACHE II, Renal Replacement Therapy