Real-life evaluation of medical intensive care transfer decision criteria for oncology patients

Medical oncology patients are increasingly being transferred to intensive care. Although the mortality of these patients is decreasing, there is still a high morbidity associated with intensive care management. This transfer is considered in the literature to be one of the criteria for aggressive end-of-life care, when it occurs during the last month of life. While it is essential that oncology patients who may benefit from transfer do not lose out, several studies suggest that EOL discussion and integrated palliative care can reduce unnecessary resuscitation at the end of life. In this sense, recent data have made it possible to identify objective prognostic factors for cancer patients transferred to the medical intensive care unit

ONCORIS is a prospective multicenter study aiming to evaluate "in real life" the criteria linked to the medical decision to transfer a cancer patient to the intensive care unit. Among other things, we aim to describe the objective and subjective factors involved in the decision, and analyze their prognostic value.

All patients with solid cancer hospitalized at the Centre Léon Bérard presenting a critical clinical situation are included over a 9-month period.

At inclusion, data are collected from the medical record concerning the characteristics of the patient and the acute event, as well as 2 questionnaires: one addressed to the physician responsible for inclusion (potentially, referring physician), the other addressed to the resuscitator if the patient is admitted.

A data collection at 3 months, allows us to collect data on their survival, their clinical evolution, their care pathway.

In case of patient's death, we are interested in the conditions of accompaniment at the end of life, with in particular the exploration of indicators of aggressiveness of end-of-life care, such as the time separating the first contact with palliative care and death.