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Original Research: CRITICAL CARE MEDICINE |

Short- and Long-term Outcomes of Critically Ill Patients With Cancer and Prolonged ICU Length of Stay

Márcio Soares, MD, PhD; Jorge I. F. Salluh, MD, MSc; Viviane B. L. Torres, MD; Juliana V. R. Leal, MS; Nelson Spector, MD, PhD
Author and Funding Information

*From the Intensive Care Unit (Drs. Soares, Salluh, and Torres, and Ms. Leal), Instituto Nacional de Câncer, and Faculdade de Medicina (Dr. Spector), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

Corrrespondence to: Márcio Soares, MD, PhD, Instituto Nacional de Câncer, Centro de Tratamento Intensivo–10° Andar, Pça. Cruz Vermelha, 23, Rio de Janeiro–RJ, Brazil; e-mail: marciosoaresms@yahoo.com.br

Dr. Soares and Dr. Spector are supported in part by individual research grants from CNPq.


This work was performed at the Intensive Care Unit of the Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil. The institutional review board approved the study and waived the need for informed consent.

Preliminary data were presented as a poster at the 20th Annual Meeting of The European Society of Intensive Care Medicine, October 7–10, 2007.

The authors have no financial or other potential conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(3):520-526. doi:10.1378/chest.08-0359
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Background:  Data on patients with cancer who have a prolonged length of stay (LOS) in the ICU are scarce. The aim of the present study was to evaluate the characteristics and the outcomes of cancer patients with life-threatening complications with an ICU stay ≥ 21 days.

Methods:  A cohort study performed at a 10-bed oncology medical-surgical ICU from May 2000 to December 2005. Prolonged ICU LOS was defined as an ICU stay ≥ 21 days.

Results:  During the period, 1,090 patients were admitted to the ICU and 163 patients (15%) had a prolonged ICU LOS. These patients, however, accounted for 48% (5,828/12,224) of the total ICU bed-days. The hospital and 6-month mortality rates were 50% and 60%, respectively, and similar to patients with ICU LOS < 21 days (51% and 61%, respectively). ICU-acquired events and complications were common, and the most frequent were infections (90%), mechanical ventilation (99%), and need for vasopressors (88%). The number of organ failures, older age, and poor performance status were the main outcome predictors. The median long-term follow-up after hospital discharge was 537 days (range, 193 to 1,119 days), and 29 patients (18%) were alive.

Conclusions:  Fifteen percent of critically ill patients with cancer had a prolonged ICU LOS. Short- and long-term survival rates were reasonable, and the prognosis was better than expected a priori. In our opinion, the length of ICU admission per se should not be used in the clinical decisions regarding the continuation of treatment in these patients.


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