Evaluation of the Prognosis of Cancer Patients Treated in Intensive Care Units

Abstract

Objective: The number of cancer cases and mean life expectancy are increasing with improvements in diagnosis and treatment options. This increase creates the need for intensive care units (ICUs) for cancer patients. This study aimed to determine the risk factors associated with admission of cancer patients to the ICU, intensive care prognosis, and mortality rates and cost per patient.Materials and Methods: In this study, we analyzed the data of cancer patients who were followed up in Pamukkale University Faculty of Medicine, Anesthesiology ICU. The variables that were analyzed included intensive care prognosis, mortality rates, risk factors affecting mortality, and cost per patient. ICU patient's folders, epicrisis reports, and follow-up documents of 251 patients with solid or systemic malignancies who were admitted to the ICU of Pamukkale University Faculty of Medicine, Anesthesiology Department for a period of two-years were analyzed.Results: The most common reason for admission to ICU for patients with solid or systemic malignancies was respiratory failure 63.34% (n=159) followed by sepsis 16.33% (n=41) and cardiac arrest 5.17% (n=13). According to the cancer staging of the patients, 58.5% (n=147) were classified as stage 4 and 16.3% (n=41) as stage 3. The cost per patient per day in the ICU ranged from 186.86 Turkish Liras (TL) to 4407.39 TL and the mean cost was 1628.49 +/- 524.12 TL. The mortality rate among these cancer patients was 89.2%.Conclusion: Most of the cancer patients died in the ICU with high medical expenses. When patients are evaluated for admission to the ICU, the patient's primary physician and ICU physician should reach a consensus as to whether the patient is in a terminal condition or not and whether palliative care should be administered to them.