Postoperative gynecologic oncology admissions to intensive care unit in the tertiary care center: an eight-year retrospective study

Ginekol Pol. 2022 Nov 30. doi: 10.5603/GP.a2022.0133. Online ahead of print.

Abstract

Objectives: The purpose of the study was to analyze the cohort of gynecologic oncology patients admitted to intensive care unit (ICU).

Material and methods: We conducted a retrospective study including all ICU postoperative admissions related to adult female patients with gynecological malignancies diagnosis treated in the tertiary care center between Jan 1, 2007, and Dec 31, 2014.

Results: A total of 666 women were admitted to ICU. It accounted for 2 % of all tertiary care center gynecology admissions. The mean age was 62.4 ± 12.7 years, and the mean length of stay was 8.9 ± 9.6 days. One hundred seventeen women (17.5%) required mechanical ventilation, and 220 women (33%) vasoactive drug infusion. The most common malignancy in the observed cohort of patients was ovarian cancer 326 (48.9%), followed by endometrial cancer 206 (30.9%). The patients with respiratory or circulatory insufficiency were older (mean age 64.9 ± 11.8 vs 60.8 ± 13; p < 0.001) and had longer mean ICU stay (13.1 ± 13.9 vs 6.3 ± 3.5 days; p < 0.001). We found a decrease in ICU admissions of patients without respiratory and circulatory failure after elective major surgery (Spearman: r = -1, p = 0.017). We report 21 patients' deaths (3.1% in the cohort; 0.06% of all admissions).

Conclusions: Ovarian cancer patients were the largest group in the study, representing almost half of ICU admissions in the gynecology oncologic population. Older age was the risk factor of respiratory and circulatory insufficiency. Availability of intermediate care facilities could reduce ICU admissions after major surgery.

Keywords: admission; critical care; gynecologic oncology; intensive care; risk factor.