The following is a summary of “Critically ill metastatic cancer patients returning home after unplanned ICU stay: an observational, multicentre retrospective study,” published in the May 2023 issue of Critical Care by Gonzalez et al. 

There is limited data on the functional outcome of critically ill metastatic cancer patients after unplanned ICU admission. Researchers performed a retrospective study to assess factors associated with 90-day return home and 1-year survival in critically ill metastatic cancer patients. In a multicentre study, they involved all consecutive metastatic cancer patients who were admitted to the ICU for unplanned reasons between 2017 and 2020.

The results showed that of 253 patients with a predominant presence of lung cancer, 37.2% (94) achieved a return home within 90 days. The one-year survival rate was 28.5%. Factors such as performance status 0 or 1 (OR 2.18; 95% CI 1.21–3.93; P=0.010), absence of malnutrition (OR 2.90; 95% CI 1.61–5.24; P<0.001), female gender (OR 2.39; 95% CI 1.33–4.29; P=0.004), recent chemotherapy (OR 2.62; 95% CI 1.40–4.90; P=0.003), and SOFA score ≤5 on admission (OR 2.62; 95% CI 1.41–4.90; P=0.002) significantly predicted a 90-day return home. Malnutrition (HR 1.66; 95% CI 1.18–2.22; P=0.003), admission due to acute respiratory failure (HR 1.40; 95% CI 1.10–1.95; P=0.043), SAPS II on admission (HR 1.03; 95% CI 1.02–1.05; P<0.001), and decisions to forgo life-sustaining therapies (DFLST) (HR 2.80; 95% CI 2.04–3.84; P<0.001) were independent indicators of 1-year mortality.

They concluded one-third of metastatic cancer patients could return home after unplanned ICU admission.

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01170-5