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Study reveals extent of cancer cases in hospital ICUs

Thursday November 2, 2017

Study reveals extent of cancer cases in hospital ICUs

A landmark review of more than 1.6 million admissions to Australian and New Zealand intensive care units will enable hospitals and healthcare authorities to better target management of particular cancers.

The analysis revealed that nearly 214,000 admissions to hospital intensive care units (ICUs) between 2000 and 2016 were due to cancer, and examined the types of cancers in hospital ICU admissions, the age of patients and mortality rates.

Dr Eamon Raith, an intensive care speciality trainee at the Royal Adelaide Hospital and Dr Claire Frauenfelder, a surgical specialty trainee at Royal Adelaide Hospital, will be presenting their findings on Friday November 3 at an anaesthetists’ conference in Sydney.

The number of admissions to ICU for patients with cancer increased from 3894 admissions (10 per cent of ICU admissions) in 2000 to 21,541 admissions in 2016 (14 per cent of all ICU admissions in 2016).

The analysis found that 78.7 per cent of patients were admitted to ICU following surgery related to their cancer, with gastrointestinal, brain and respiratory tract cancers (including lung cancer) being the most common.

Despite the increased number of admissions to ICU, the mortality rate for all patients admitted to ICU with cancer fell, from 17.7 per cent in 2000 to 8.43 per cent in 2016.

Dr Raith said the findings were significant because it “tells us what types of cancers were admitted to Australian and New Zealand intensive care units between 2000 and 2016, how that has changed over time and which factors are associated with an increase in the risk of dying in ICU or in hospital.”

“It allows us to assess the outcomes for patients with cancer in the ICU so we can determine if we are getting the best results possible for these patients. We can look back over time and see what trends have evolved; this then guides potential interventions and future research to improve treatment for these patients,” he explained.

Dr Raith said the study examined patient data from the Australia and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation which collects data from ICUs throughout both countries.

“These patients have been admitted to ICU because of their cancer. For example, it might be someone who has had an operation to remove a tumour and who needs ICU support or someone with blood cancer who is admitted to the ICU because they have very low platelet levels,” Dr Raith said.

“This study aims to better inform decisions around ICU admissions and help guide decisions around therapy and interventions before, during and after surgical and medical treatment for all cancer patients.”

According to the Australian Institute of Health and Welfare’s Cancer in Australia 2017 report lung cancer is the leading cause of cancer death followed by colorectal cancer, prostate cancer, breast cancer and pancreatic cancer.

“We want to know more about what happens to cancer patients who come into the ICU. Hopefully this study can be used to develop further research aimed at improving treatment and outcomes for critically ill cancer patients,’’ Dr Raith said.

NB: As there’s no specific breakdown on the NZ data, Dr Raith can’t quantify the situation in New Zealand but he can talk generally about the trends in both countries.

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