Survival Outcomes and Cancer Treatment Post-ICU Stay

Sep 04, 2024

The following is a summary of “Factors associated with cancer treatment resumption after ICU stay in patients with solid tumors,” published in the August 2024 issue of Critical Care by Benguerfi et al.

Post-intensive care syndrome might have caused the inability to receive cancer treatment after an ICU stay in patients with solid tumors (ST).

Researchers conducted a retrospective study to determine the factors associated with cancer treatment resumption and the impact of treatment on the outcome of patients with ST after ICU stay.

They conducted a retrospective study of all patients with ST admitted to a French University-affiliated Hospital to the ICU between 2014 and 2019.

The results from 219 patients indicated a median SAPS II score at ICU admission of 44.0 [IQR 32.8, 66.3]. Of about 136 patients who survived their ICU stay, 81 (59.6%) received cancer treatment after discharge. An increase in patients with a poor performance status (PS) of 3 or 4 following the ICU stay (16.2% at admission vs. 44.5% among survivors), with a significant decline in PS after the ICU stay (median difference −1.5, 95% CI [-1.5 to -1.0], P< 0.001) was observed. The change in PS (delta PS) was directly linked with the inability to receive cancer treatment (odds ratio [OR] 0.34, 95% CI 0.18–0.56, P < 0.001) and with 1-year mortality in survivors (hazard ratio [HR] 1.76, 95% CI 1.34–2.31, P< 0.001). PS before the ICU stay (OR 3.73, 95% CI 2.01–7.82, P< 0.001) and length of stay (OR 1.23, 95% CI 1.06–1.49, P= 0.018) were independently associated with poor PS after the ICU stay. Survival rates at ICU discharge, 1 year, and 3 years were 62.3% (n = 136), 27.3% (n = 59), and 17.1% (n = 37), respectively. The median survival for patients who resumed cancer treatment after the ICU stay was 771 days (95% CI 376–1058), compared to 29 days (95% CI 15–49) for those who did not resume treatment (P< 0.001).