Factors Influencing Intensive Care Unit Outcomes in Elderly Patients with Solid Organ Tumors

Aim:The increasing incidence of cancer in the older population presents challenges in intensive care units (ICU) due to age-associated complications and critical illness.Despite advancements in cancer treatment, the management of patients in the ICU remains complicated, with conflicting reports on outcomes.Therefore, in this study, we aimed to investigate the factors influencing ICU outcomes to guide the management and overall care of this vulnerable patient population.Methods: This retrospective cohort study was conducted in a 9-bed tertiary medical ICU of Gazi University Hospital from July 2019 to January 2023 to investigate factors influencing ICU outcomes in elderly patients with solid organ tumors.The primary outcome measure of the study was ICU mortality.Results: Among 123 critically ill elderly patients with solid organ tumors, the ICU mortality rate was 58%.ICU non-survivors had higher rates of metastatic disease (85% vs. 33%, p<0.01), underlying chronic obstructive pulmonary disease (45% vs. 27%, p=0.03), higher Acute Physiology and Chronic Health Evaluation II (APACHE II) [27 (24-34) vs. 15 (12-19), p<0.01],Sequential Organ Failure Assessment [10 (6-15) vs. 4 (2-5), p<0.01] and lower Glasgow Coma Scale scores [13 (10-15) vs. 15 (13-15), p=0.01].ICU non-survivors also had higher rates of sepsis (72% vs. 50%, p=0.01) and shock (80% vs. 35%, p<0.01) and lower albumin levels (2.30.5 vs. 2.60.6,p=0.03) at ICU admission.Sepsis at ICU admission [odds ratio (OR) 95% confidence interval (CI): 5.5 (1.8-17.4),p<0.01], presence of metastasis [OR (95% CI): 2.12 (1.41-4.32),p<0.01],APACHE II score [OR (95% CI): 1.8 (1.29-2.51),p<0.01] and invasive mechanical ventilation [OR (95% CI): 1.56 (1.14-2.01),p=0.01] were found as independent risk factors for ICU mortality in this patient population.Conclusion: Metastasis, sepsis upon ICU admission, APACHE II score, and requirement for invasive mechanical ventilation were independent risk factors for ICU mortality in elderly patients with solid organ tumors.Future studies should validate these findings in larger cohorts and focus on disease states and treatment modalities.