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Over the past decades, both critical care and cancer care have improvedsubstantially. Due to increased cancer-specific survival, we hypothesized thatboth the number of cancer patients admitted to the ICU and overall survivalhave increased since the millennium change. MIMIC-III, a freely accessiblecritical care database of Beth Israel Deaconess Medical Center, Boston, USA wasused to retrospectively study trends and outcomes of cancer patients admittedto the ICU between 2002 and 2011. Multiple logistic regression analysis wasperformed to adjust for confounders of 28-day and 1-year mortality.  Out of 41,468 unique ICU admissions, 1,100 hemato-oncologic, 3,953 oncologicand 49 patients with both a hematological and solid malignancy were analyzed.Hematological patients had higher critical illness scores than non-cancerpatients, while oncologic patients had similar APACHE-III and SOFA-scorescompared to non-cancer patients. In the univariate analysis, cancer wasstrongly associated with mortality (OR= 2.74, 95%CI: 2.56, 2.94). Over the10-year study period, 28-day mortality of cancer patients decreased by 30%.This trend persisted after adjustment for covariates, with cancer patientshaving significantly higher mortality (OR=2.63, 95%CI: 2.38, 2.88). Between2002 and 2011, both the adjusted odds of 28-day mortality and the adjusted oddsof 1-year mortality for cancer patients decreased by 6% (95%CI: 4%, 9%). Havingcancer was the strongest single predictor of 1-year mortality in themultivariate model (OR=4.47, 95%CI: 4.11, 4.84).

Improved survival of cancer patients admitted to the ICU between 2002 and 2011 at a U.S. teaching hospital