Outcomes of intensive care unit admissions after elective cancer surgery

Eur J Surg Oncol. 2013 Jun;39(6):584-92. doi: 10.1016/j.ejso.2013.02.014. Epub 2013 Mar 11.

Abstract

Background: Postoperative care for major elective cancer surgery is frequently provided on the Intensive Care Unit (ICU).

Objective: To analyze the characteristics and outcome of patients after ICU admission following elective surgery for different cancer diagnoses.

Methods: We analyzed all ICU admissions following elective cancer surgery in the Netherlands collected in the National Intensive Care Evaluation registry between January 2007 and January 2012.

Results: 28,973 patients (9.0% of all ICU admissions; 40% female) were admitted to the ICU after elective cancer surgery. Of these admissions 77% were planned; in 23% of cases the decision for ICU admission was made during or directly after surgery. The most frequent malignancies were colorectal cancer (25.6%), lung cancer (18.5%) and tumors of the central nervous system (14.3%). Mechanical ventilation was necessary in 24.8% of all patients, most frequently after surgery for esophageal (62.5%) and head and neck cancer (50.2%); 20.7% of patients were treated with vasopressors in the acute postoperative phase, in particular after surgery for esophageal cancer (41.8%). The median length of stay on the ICU was 0.9 days (interquartile ranges [IQR] 0.8-1.5); surgery for esophageal cancer was associated with the longest ICU length of stay (median 2.0 days) with the largest variation (IQR 1.0-4.8 days). ICU mortality was 1.4%; surgery for gastrointestinal cancer was associated with the highest ICU mortality (colorectal cancer 2.2%, pancreatico-cholangiocarcinoma 2.0%).

Conclusion: Elective cancer surgery represents a significant part of all ICU admissions, with a short length of stay and low mortality.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Central Nervous System Neoplasms / mortality
  • Central Nervous System Neoplasms / therapy
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / therapy
  • Critical Care / methods*
  • Critical Care / statistics & numerical data*
  • Drug Prescriptions / statistics & numerical data
  • Elective Surgical Procedures* / mortality
  • Elective Surgical Procedures* / statistics & numerical data
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / therapy
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / therapy
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data
  • Lung Neoplasms / mortality
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Neoplasms / mortality*
  • Neoplasms / surgery
  • Neoplasms / therapy*
  • Netherlands / epidemiology
  • Patient Admission / statistics & numerical data*
  • Registries
  • Respiration, Artificial / statistics & numerical data
  • Treatment Outcome
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents