Does the risk of critical illness among cancer patients make a significant contribution to cancer outcomes? A population-based observational study of 118,571 adults from the Scottish cancer registry

Morrison, D., McLoone, P. , Puxty, K., Quasim, T. and Kinsella, J. (2015) Does the risk of critical illness among cancer patients make a significant contribution to cancer outcomes? A population-based observational study of 118,571 adults from the Scottish cancer registry. European Journal of Cancer Care, 24(S1), pp. 18-19. (doi: 10.1111/ecc.12329) (PMID:26040926)

Abstract

Background: Survival from cancer is poorer in the UK than other European countries. Critical illness may be a potential determinant of cancer outcomes but its role has not been described before. We assessed the incidence of admission to intensive care units (ICU) following cancer diagnosis to quantify the risk of critical illness among cancer patients. Method: We took data for solid cancer registrations in the West of Scotland region, UK, between 2000–2009 from the Scottish Cancer Registry. Linked hospital, ICU, and mortality records provided details of hospital admissions, deaths, sociodemographics and comorbidities. We assessed the incidence of admission to ICU within two years of cancer diagnosis and explored differences in hospital mortality by patient characteristics. Results: 6,121 (5.2%,95% CI 5.0–5.3%) out of 118,571 incident cancer patients developed a critical illness and were admitted to ICU within 2 years. Risk of critical illness was highest at ages 60–69 and higher in men. The cumulative inci-dence of critical illness was greatest for small intestinal (17.2%,95% CI 13.3–21.8%) and colorectal cancers (16.5%,15.9–17.1%). The risk following breast cancer was low (0.8%,95% CI 0.7–1.0%). Mortality in ICU was 14.1% (95% CI 13.3–15.0%), and during the hospital stay 24.6% (23.5– 25.7%). Mortality was greatest among emergency medical admissions and lowest among elective surgical patients. The risk of critical illness did not vary by socio-economic circumstances but mortality was higher among patients from deprived areas. Conclusions: About one in 20 cancer patients experiences a critical illness resulting in ICU admission within two years of cancer diagnosis. They experience high mortality which may make a significant contribution to cancer outcomes. The UK has lower provision of ICU than countries in which cancer survival is better. It is important to determine whether provision of ICU resources might reduce critical illness mortality among cancer patients.

• Item Type: Articles (Other)
• Status: Published
• Refereed: No
• Glasgow Author(s) Enlighten ID: McLoone, Mr Philip and Morrison, Dr David and Quasim, Professor Tara and Kinsella, Professor John
• Authors: Morrison, D., McLoone, P., Puxty, K., Quasim, T., and Kinsella, J.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Journal of Cancer Care
• Publisher: Wiley-Blackwell Publishing Ltd.
• ISSN: 0961-5423
• ISSN (Online): 1365-2354
• Published Online: 03 June 2015