Multidisciplinary onco–critical care management: Clinical impact.

Abstract

e13568 Background: Advances in cancer diagnosis and treatment have increased survival, resulting in a growing number of patients (pts) at risk of acute, life-threatening complications requiring ICU evaluation. Although ICU admission was historically considered of limited benefit in oncology, recent evidence shows that selected pts with good functional status and potentially reversible conditions have outcomes comparable to non-oncological pts. Multidisciplinary ICU–Oncology committees may optimize patient selection, define appropriate therapeutic ceilings, and support individualized, evidence-based decision-making. Methods: Single-center, retrospective observational study at Juan Ramón Jiménez University Hospital (Huelva, Spain) after implementation of a multidisciplinary Onco–Critical Care Committee. Adult hospitalized patients with solid tumors evaluated between June 1 and December 31, 2025 were included. Demographic, oncologic, functional, ICU-related variables, and outcomes were collected. Prognostic factors were reviewed to guide ICU admission suitability. Descriptive analysis was performed using SPSS v21. Results: 55 pts were analyzed; median age was ~65 years and 60% were male. Most pts had good or intermediate functional status (ECOG 0–2: 87%), advanced disease (stage IV: 62%), and an estimated survival > 1 year (73%). Lung (21,8%), colorectal (12,7%), and breast cancers (10,9%) were the most frequent tumors. Main reasons for evaluation were cancer-related complications and treatment toxicity. The committee classified 56.6% as ICU candidates without limitations and 18.9% with limitations; 21.8% were ultimately admitted to ICU. Among ICU-admitted patients, illness severity was moderate (mean APACHE II 19.4), with frequent need for organ support. ICU survival was high (90%), while overall hospital mortality was 33%. Post-ICU syndrome was observed in approximately half of survivors. (Table 1). Conclusions: The implementation of a multidisciplinary Onco–Critical Care Committee enabled structured, individualized, and anticipatory decision-making regarding ICU admission in oncology patients. This collaborative approach facilitated appropriate patient selection, optimized use of critical care resources, and was associated with high ICU survival, underscoring the clinical value of integrating oncology and critical care teams in routine practice. Baseline characteristics and clinical outcomes. Variable Value Tumor TypesLungColorectalBreastProstate 21.8%12.7%10.9%7.3% Treatment modalityRadical intentPeroperative intentPalliative intent 20%28%45.5 % ICU supportMechanical ventilation (%)Vasopressors use (%)Renal replacement therapy (%) 33%50%50%