Primary brain tumors admitted to the neurological intensive care unit: a single institution observational study (P1.6-009)

Objective: We sought to identify demographic, admission and discharge characteristics of patients with known primary brain tumors (PBTs) admitted to our neurological intensive care unit (ICU).

Background: A paucity of data exists that describe outcomes of PBT patients admitted to an ICU in the United States. ICUs are reluctant to admit these patients due to the presumption that they will do poorly.

Design/Methods: This is a single institution retrospective analysis of adult patients with PBTs admitted to an ICU at Duke University Hospital between 7/1/13 – 4/12/18. Patients were identified from DUMC’s neurocritical care and brain tumor databases. Patient demographics, tumor characteristics, admission diagnoses, disposition and survival data were collected from the databases and medical record review. Descriptive analysis was performed. Survival time was determined from date of admission to ICU to date of death.

Results: 247 patient encounters were identified; however, 147 were excluded due to a length of stay ≤2 days (predominantly patients admitted for elective resection), resulting in 100 patient encounters that were included in the analysis. There was a total of 94 patients who comprised the 100 encounters. The predominant histologic diagnosis was glioblastoma (WHO grade IV) (n=62, 62%). The mean age was 34 yrs (range 19–78). 35 unique diagnoses for admission were identified. The most common admission indications were for clinical trial related catheter infusions (n=33, 33%) and status epilepticus (n=11, 11%). Among the 67 encounters that were not clinical trial related, the discharge disposition of patients was: 11 expired, 8 discharged to hospice, 2 to long-term care, 20 to rehabilitation facility, and 26 home. Median survival time for all patients was 370 days (95% CI: 246–511).

Conclusions: This is the first descriptive analysis of patients in the United States with PBTs admitted to an ICU. The majority of patients had a favorable discharge disposition.

Disclosure: Dr. Kang has nothing to disclose. Dr. Swisher has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Eisai and UCB. Dr. Kirkpatrick has nothing to disclose. Dr. Herndon II has nothing to disclose. Dr. Lipp has nothing to disclose. Dr. Thomas has nothing to disclose. Dr. Johnson has nothing to disclose. Dr. Ashley has nothing to disclose. Dr. DesJardins has received compensation for serving on the Board of Directors of Istari Oncology. Dr. DesJardins has received research support from Symphogen, Orbus Therapeutics, and Triphase Accelerator Corporation. Dr. Randazzo has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novocure. Dr. Friedman has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Genentech - consultant and advisory board / Istari - Chief Medical Officer and patent. Dr. Friedman has received compensation for serving on the Board of Directors of Genentech - consultant and advisory board / Istari - Chief Medical Officer and patent. Dr. Peters has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Abbvie, Agios, Eisai, Monteris, and Novocure. Dr. Peters has received research support from Abbvie, Agios, Biomimetix, Eisai, Monteris, Novocure, BMS-Research Protocols and Clinical Trials.