Clinical features and outcomes of patients with pancreatic cancer requiring unplanned medical ICU admission: A retrospective multicenter study

• Published in: Digestive and liver disease Vol. 56; no. 3; pp. 514 - 521
• Main Authors: Kemoun, G., Weiss, E., El Houari, L., Bonny, V., Goury, A., Caliez, O., Picard, B., Rudler, M., Rhaiem, R., Rebours, V., Mayaux, J., Bachet, J.B., Belin, L., Demoule, A., Decavèle, M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2024
• Subjects: Biliary tract infection; Oncology; Sepsis; Biliary tract infection; Oncology; Sepsis
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2023.08.049

We sought to describe the reasons for intensive care unit (ICU) admission and outcomes of patients with pancreatic cancer requiring unplanned medical ICU admission. Retrospective cohort study in five ICUs from 2009 to 2020. All patients with pancreatic cancer admitted to the ICU were included. Patients having undergone recent surgery were excluded (< 4 weeks). 269 patients were included. Tumors were mainly adenocarcinoma (90%). Main reason for admission was sepsis/septic shock (32%) with a biliary tract infection in 44 (51%) patients. Second reason for admission was gastrointestinal bleeding (28%). ICU and 3-month mortality rates were 26% and 59% respectively. Performance status 3–4 (odds ratio OR 3.58), disease status (responsive/stable -ref-, newly diagnosed OR 3.25, progressive OR 5.99), mechanical ventilation (OR 8.03), vasopressors (OR 4.19), SAPS 2 (OR 1.69) and pH (OR 0.02) were independently associated with ICU mortality. Performance status 3–4 (Hazard ratio HR 1.96) and disease status (responsive/stable -ref-, newly diagnosed HR 2.67, progressive HR 4.14) were associated with 3-month mortality. Reasons for ICU admissions of pancreatic cancer patients differ from those observed in other solid cancer. Short- and medium-term mortality are strongly influenced by performance status and disease status at ICU admission.