Outcome of glioblastoma patients after intensive care unit admission with invasive mechanical ventilation: A multicenter analysis

Abstract

Abstract Purpose Patients with glioblastoma (GB) bear a severe symptom burden, often leading to complications that mandate admission to an intensive care unit (ICU) and mechanical ventilation (MV). However, published data on patients with GB admitted to ICU for MV are rare. Therefore, we investigated reasons for admission, duration of hospitalization and outcome of patients with GB and unplanned admission to ICU needing MV. Methods In this retrospective analysis, four certified interdisciplinary brain tumor centers performed a retrospective review of their electronic data systems. All patients with GB admitted to an in-house ICU and mechanically ventilated between January 2015 and December 2019 were included. Clinical and prognostic factors as well as relevant outcome parameters were evaluated by group comparisons and Kaplan Meier survival curves. Results We identified 33 GB patients with a mean time of MV of 9.2 ± 9.4 days. Main reasons for ICU admission were infection (n = 12; 34.3%) including 3 cases of Pneumocystis jirovecii pneumonia, status epilepticus (31.4%) and elevated intracranial pressure (22.9%). In hospital mortality reached 60.6%. Younger age, short course of GB, low number of MV days, and better Karnofsky Performance Status Scale before admission were significantly associated with positive prognostic outcome. Conclusion We conclude that less than 50% of patients with GB have a favorable short-term outcome when unplanned treatment on ICU with MV is necessary. Our data mandate a careful therapy guidance and frequent reevaluation of goals during ICU stay.