Analysis of Intent and Reason for Oncologic Therapy Administration in Cancer Patients Admitted to the Intensive Care Unit

David Shaz, Stephen M. Pastores, Lokesh Dayal, Justin Berkowitz, Natalie Kostelecky, Kay See Tan, Neil Halpern

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate the intent of, and reason for, administration of oncologic therapies in the intensive care unit (ICU). Methods: Single center, retrospective, cohort study of patients with cancer who received oncologic therapies at a tertiary cancer center ICU between April 1, 2019 and March 31, 2020. Oncologic therapies included traditional cytotoxic chemotherapy, targeted therapy, immunotherapy, hormonal or biologic therapy directed at a malignancy and were characterized as initiation (initial administration) or continuation (part of an ongoing regimen). Results: 84 unique patients (6.8% of total ICU admissions) received oncologic therapies in the ICU; 43 (51%) had hematologic malignancies and 41 (49%) had solid tumors. The intent of oncologic therapy was palliative in 63% and curative in 27%. Twenty-two (26%) patients received initiation and 62 (74%) received continuation oncologic therapies. The intent of oncologic therapy was significantly different by regimen type (initiation vs. continuation, p = <0.0001). Initiation therapy was more commonly prescribed with curative intent and continuation therapy was more commonly administered with palliative intent (p = <0.0001). Oncologic therapies were given in the ICU mainly for an oncologic emergency (56%) and because the patients happened to be in the ICU for a non-oncologic critical illness when their oncologic therapy was due (34.5%). Conclusion: Our study provides intensivists with a better understanding of the context and intent of oncologic therapies and why these therapies are administered in the ICU.

Original languageEnglish
Pages (from-to)1305-1311
Number of pages7
JournalJournal of Intensive Care Medicine
Volume37
Issue number10
DOIs
StatePublished - Oct 2022
Externally publishedYes

Keywords

  • cancer
  • chemotherapy
  • critical care
  • intensive care unit
  • oncologic therapy

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