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- W2891849133 abstract "e18108 Background: Based on prior studies, cancer pts admitted (atd) to ICU have poor outcome but gastrointestinal(GI) cancers have not been studied separately. We evaluated outcomes of GI cancer pts receiving active therapy (Rx) who were admitted to the ICU with the goal of informing physicians and pts regarding goals of care. Methods: We retrospectively evaluated pts with GI cancer on active chemo Rx in past 6 months who were admitted to the ICU from 2011-2016. Out of 375, 115 pts met the inclusion criteria. (85 = CRC, 30 = other GI malignancy). Results: The mean age was 71 (51% males). 75% stage 4, 42% had liver, 28% peritoneal, and 21% lung mets. The median duration of the last chemo dose was 2 wks. The median ICU length of stay was 3 days. 25% had neutropenia on admission. 64% had prior cancer related surgery, and 31% had prior radiation. 23% were atd due to cancer progression (CP), 19% due to potentially reversible cancer complications (pRCC), and 57% due to therapy complications (TC).Most common admitting diagnoses were: pneumonia (25.9%), abdominal infection (27%), PE/DVT/MI (20%), febrile neutropenia (10%). During ICU stay, 29% had ventilator dependent respiratory failure (VDRF), 53% had sepsis, 43% had renal failure (RF) and 17% had liver failure(LF). Median survival after ICU admit was 2 weeks (0-75). 15.5% were DNR at ICU admission and 82.8% were full code. 55.2% had palliative talk. After DC, 38.8% went back on Rx and 41% chose hospice. Readmission was 15.5%. In-hospital mortality (IHM) was 24.1% overall, and highest in those with LF (50%, p = .008), sepsis, and RF (34% each, p = .048). IHM was 33% in pts with CP (p value-0.201), 31% in patients with a pRCC (p-value 0.204), 18% in pts with a TC(p-value 0.092), and 52% in pts with VDRF(p-value 0.000). Overall, 56% were dead at 30 days, 65% at 90-days and 73% at 180 days. Conclusions: Our study suggests that in-hospital, 30-, 90- and 180-day mortality in GI cancer patients on active Rx admitted to the ICU was high, particularly in patients admitted with progressive cancer and/or with organ dysfunction. Most patients were full code and had not had prior documented GOC discussions. These results highlight the importance of early realistic GOC discussions for this population." @default.
- W2891849133 created "2018-09-27" @default.
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- W2891849133 date "2017-05-20" @default.
- W2891849133 modified "2023-09-27" @default.
- W2891849133 title "Outcome of gastrointestinal cancer patients (pts) after ICU admission: The Abington Memorial Hospital (AMH) experience." @default.
- W2891849133 doi "https://doi.org/10.1200/jco.2017.35.15_suppl.e18108" @default.
- W2891849133 hasPublicationYear "2017" @default.
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