Outcomes of Cancer Patients Requiring Non-elective Medical Admission to the Intensive Care Unit of a Tertiary Care Center in India: A 5-year Retrospective Study

Background and aims: In India, where cancer incidence is rising, and healthcare infrastructure in tertiary care centers is strained, the outcomes of cancer patients requiring intensive care unit (ICU) care remain poorly understood.We aim to describe demographic, clinical, and survival data and to identify factors associated with mortality in non-elective medical admissions of critically ill cancer patients to ICU in a tertiary care hospital.Patients and methods: Retrospective observational study of non-elective medical admissions of critically ill adult cancer patients to the ICU with a diagnosis of solid organ or hematological malignancies between 1st January 2018 and 31st December 2022.Data regarding patient and neoplasm characteristics, ICU admission features, and outcomes were collected from medical records and ICU charts.Results: A total of 204 non-elective medical admissions of critically ill cancer patients to the ICU were analyzed.Hematological malignancies were documented in 53.9% patients.The main causes of admission to the ICU were febrile neutropenia (34.3%), respiratory failure (31.8%), sepsis (9.8%), and shock (7.8%).The mean length of ICU stay was 5.62 ± 5.67 days.Intensive care unit mortality was 52.94%.The most common cause of mortality was septic shock (53.7%).The need for invasive mechanical ventilation (IMV) [adjusted odds ratio (OR) 0.113; 95% confidence interval (CI) 15.98 (4.22-60.56),p < 0.001], use of vasopressors (adjusted OR 12.59; 95% CI: 3.45-45.94,p < 0.001), need for dialysis (adjusted OR 17.99; 95% CI: 1.97-164.45,p = 0.01), and tracheostomy (adjusted OR 0.15; 95% CI: 0.03-0.7,p = 0.016), were independent risk factors associated with higher ICU mortality.Conclusion: An increasing number of cancer patients require intensive care, and our study suggests that many of these patients have a reasonable chance of surviving their ICU stay.The in-ICU mortality of 52.94% was observed at our tertiary care center in India.Independent predictors of mortality included age, type of malignancy, treatment intent, need for early IMV, vasopressors, and dialysis in the ICU.