  Over the past decades, both critical care and cancer care have improved
substantially. Due to increased cancer-specific survival, we hypothesized that
both the number of cancer patients admitted to the ICU and overall survival
have increased since the millennium change. MIMIC-III, a freely accessible
critical care database of Beth Israel Deaconess Medical Center, Boston, USA was
used to retrospectively study trends and outcomes of cancer patients admitted
to the ICU between 2002 and 2011. Multiple logistic regression analysis was
performed to adjust for confounders of 28-day and 1-year mortality.
  Out of 41,468 unique ICU admissions, 1,100 hemato-oncologic, 3,953 oncologic
and 49 patients with both a hematological and solid malignancy were analyzed.
Hematological patients had higher critical illness scores than non-cancer
patients, while oncologic patients had similar APACHE-III and SOFA-scores
compared to non-cancer patients. In the univariate analysis, cancer was
strongly associated with mortality (OR= 2.74, 95%CI: 2.56, 2.94). Over the
10-year study period, 28-day mortality of cancer patients decreased by 30%.
This trend persisted after adjustment for covariates, with cancer patients
having significantly higher mortality (OR=2.63, 95%CI: 2.38, 2.88). Between
2002 and 2011, both the adjusted odds of 28-day mortality and the adjusted odds
of 1-year mortality for cancer patients decreased by 6% (95%CI: 4%, 9%). Having
cancer was the strongest single predictor of 1-year mortality in the
multivariate model (OR=4.47, 95%CI: 4.11, 4.84).
