Abstract
BACKGROUND: Emergency ICU transfers in neuro-oncology patients signify critical disease progression or treatment complications. We analyzed clinical indicators, interventions, and survival outcomes to identify high-risk populations and optimize palliative transitions. METHODS: Retrospective review of neuro-oncology patients (brain metastases, gliomas, medulloblastoma, germ cell tumors) transferred emergently to ICU (2023–2024). Data included transfer triggers (hypoxia, seizures, etc.), interventions (intubation, resuscitation), and survival. Statistics: Descriptive analysis, Kaplan-Meier for OS. RESULTS: Among 149 patients (median age 53, male 100, female 49), primary diagnoses: brain metastases 87(58.4%), gliomas 46 (30.9%), others 16 (10.8%). Transfer triggers: hypoxia 123 (82.6%), seizures 6(4.3%), brain herniation 3(2.0%), others 17(11.4%). Pre-ICU median KPS:50; GCS ≤8, 51(34.2%). ICU interventions: intubation 75(50.3%), tracheostomy tube 8(5.7%), symptomatic management33 (22.1%). Mortality rate in 1 week: 27.5% (41/149), (median OS post-transfer: 15 days). Survivors 49 (32.9%) had higher pre-ICU KPS (p=0.012. 32.9% received palliative care post-ICU. CONCLUSION: Hypoxia and brain herniation were dominant ICU transfer triggers with poor survival (median OS <1.5 weeks). Early palliative integration is warranted for patients with pre-ICU KPS ≤60 or GCS ≤8. Protocolized advance care planning may reduce futile interventions.