Characteristics and outcomes of patients with solid tumors receiving chemotherapy in the intensive care unit Journal Article


Authors: Shaz, D. J.; Pastores, S. M.; Goldman, D. A.; Kostelecky, N.; Tizon, R. F.; Tan, K. S.; Halpern, N. A.
Article Title: Characteristics and outcomes of patients with solid tumors receiving chemotherapy in the intensive care unit
Abstract: Abstract: Purpose: The objective of this study was to evaluate the short- and long-term outcomes of adult patients with solid tumors receiving chemotherapy in the intensive care unit (ICU). Methods: This was a retrospective single-center study comparing the outcomes of patients with solid tumors who received chemotherapy in the ICU with a matched cohort of ICU patients (by age, sex, and tumor type) who did not receive chemotherapy. Conditional logistic regression and shared frailty Cox regression were used to assess short-term (ICU and hospital) mortality and death by 12-month post-hospital discharge, respectively. Results: Seventy-three patients with solid tumors who received chemotherapy in the ICU were successfully matched. The most common solid tumors included thoracic (30%), genitourinary (26%), and breast (16%). The ICU, hospital, and 12-month (post discharge) mortality rates of patients who recieved chomtherapy in the ICU were 23%, 36%, and 43%, respectively. When compared to the matched cohort of patients who did not receive chemotherapy, patients who received chemotherapy had a significantly longer length of stay in the ICU (median 7 vs. 4 days, p < 0.001) and hospital (median 15 vs. 11 days, p = 0.011) but similar short-term ICU and hospital mortality rates (23% vs. 18% and 36% vs. 38%, respectively). Patients who received chemotherapy in the ICU were at a lower risk of death by 12 months (HR 0.31, p < 0.001) compared to the matched cohort on multivariable analysis. Conclusions: Patients with solid tumors who received chemotherapy had increased ICU and hospital length of stay compared to patients who did not. Although short-term mortality did not differ, patients who received chemotherapy in the ICU had improved long-term survival. Our data can inform critical care triage decisions to include patients who are to receive chemotherapy in the ICU. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: chemotherapy; intensive care unit; outcomes; solid tumors; cancer
Journal Title: Supportive Care in Cancer
Volume: 28
Issue: 8
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2020-08-01
Start Page: 3855
End Page: 3865
Language: English
DOI: 10.1007/s00520-019-05226-w
PUBMED: 31836938
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 July 2020 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Neil A Halpern
    126 Halpern
  2. Stephen Pastores
    166 Pastores
  3. Natalie Theresa Remor
    25 Remor
  4. Debra Alyssa Goldman
    115 Goldman
  5. David Joseph Yehuda Shaz
    5 Shaz
  6. Kay See   Tan
    113 Tan
  7. Richard Ferrariz Tizon
    3 Tizon