• Rodrigo Cavallazzi, Amyn Hirani, Tajender S Vasu, Monvasi Pachinburavan, and Gregory C Kane.
• Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, 834 Walnut St, Suite 650, Philadelphia, PA 19107, USA. rcavallazzi@gmail.com
• Am J Hosp Palliat Care. 2009 Nov 20; 26 (6): 464-9.

PurposeTo evaluate the influence of malignancy on the decision to limit life-sustaining therapy in the intensive care unit (ICU).MethodsAt the day of patients' admission to the ICU, we prospectively collected information on demographics, acute physiology and chronic health evaluation (APACHE) II score, and features related to malignancy. We retrospectively collected information on in-hospital survival and decision to withhold or withdraw life-sustaining treatment.ResultsThis study included 122 adult critically ill patients. After adjusting for age and APACHE II score, patients with malignancy had 3.02 (95% CI 1.19 to 7.62) higher odds of having life-sustaining therapy withdrawn or withheld as compared to patients without active malignancy.ConclusionOur study showed that critically ill patients with malignancy are more likely to have their life-sustaining therapy withheld or withdrawn than those without malignancy after adjusting for severity of disease. This finding may be related to a perception that critically ill patients with malignancy have worse prognosis as compared with those without malignancy.

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