Surgical patients admitted to the intensive care unit (ICU) are not homogenous and their outcomes may vary depending on their origin within the hospital. The purpose of this study was to analyze the clinical characteristics and outcomes of surgical cancer patients admitted to the ICU at a tertiary care cancer center in 2008.
Using hospital databases, we retrospectively studied all surgical patients admitted to our 20-bed medical/surgical oncologic ICU from January 1, 2008 to December 31, 2008. Patients admitted from the Urgent Care Center were excluded. Collected data included origin of admission (Operating Room [OR] or Post-Anesthesia Care Unit [PACU] and Wards), age, gender, MPM II score and blood lactate level on ICU admission, DNR status, use of mechanical ventilation (MV) and vasopressors (VP) during ICU stay, ICU and hospital lengths of stay (LOS), and ICU and hospital mortality. Chi-square and Student t-tests were used for statistical analyses. A p value of < 0.05 was considered significant.
Of 235 surgical ICU admissions, 96 (41%) came from OR/PACU and 139 (59%) were admitted from the wards. There were no statistically significant differences in age, gender, MPM II score, lactate level, DNR status, ICU LOS, post-ICU LOS, hospital LOS, and VP use between the two groups. However, pre-ICU LOS and ICU and hospital mortality rates were greater among ward admissions compared to OR/PACU admissions (Table 1). MV use was higher among OR/PACU admissions.
The outcomes of surgical cancer patients admitted to the ICU differ based on the source of their admission and pre-ICU LOS despite many similar demographic and clinical variables on ICU admission.
Further analysis is required to define additional variables besides pre-ICU LOS that can explain the worse outcome for surgical ICU patients admitted from the wards in order to optimize their treatment strategies.
Mladen Sokolovic, No Financial Disclosure Information; No Product/Research Disclosure Information