Indraprastha Apollo Hospital is an Indian hospital owned by Apollo Hospitals group, India's largest healthcare chain. Established in 1995, it is the third super specialty tertiary care hospital set by the Apollo Hospitals Group, jointly with the Government of Delhi. It is a 695-bed hospital, with the provision for expansion to 1000 beds in future. The hospital is spread over 15 acres, and has a built-up area of 600,000 square feet.
Background and aims:In India, where cancer incidence is rising, and healthcare infrastructure in tertiary care centers is strained, the outcomes of cancer patients requiring intensive care unit (ICU) care remain poorly understood. We aim to describe demographic, clinical, and survival data and to identify factors associated with mortality in non-elective medical admissions of critically ill cancer patients to ICU in a tertiary care hospital. Patients and methods:Retrospective observational study of non-elective medical admissions of critically ill adult cancer patients to the ICU with a diagnosis of solid organ or hematological malignancies between 1st January 2018 and 31st December 2022. Data regarding patient and neoplasm characteristics, ICU admission features, and outcomes were collected from medical records and ICU charts. Results:A total of 204 non-elective medical admissions of critically ill cancer patients to the ICU were analyzed. Hematological malignancies were documented in 53.9% patients. The main causes of admission to the ICU were febrile neutropenia (34.3%), respiratory failure (31.8%), sepsis (9.8%), and shock (7.8%). The mean length of ICU stay was 5.62 ± 5.67 days. Intensive care unit mortality was 52.94%. The most common cause of mortality was septic shock (53.7%). The need for invasive mechanical ventilation (IMV) [adjusted odds ratio (OR) 0.113; 95% confidence interval (CI) 15.98 (4.22-60.56), p < 0.001], use of vasopressors (adjusted OR 12.59; 95% CI: 3.45-45.94, p < 0.001), need for dialysis (adjusted OR 17.99; 95% CI: 1.97-164.45, p = 0.01), and tracheostomy (adjusted OR 0.15; 95% CI: 0.03-0.7, p = 0.016), were independent risk factors associated with higher ICU mortality. Conclusion:An increasing number of cancer patients require intensive care, and our study suggests that many of these patients have a reasonable chance of surviving their ICU stay. The in-ICU mortality of 52.94% was observed at our tertiary care center in India. Independent predictors of mortality included age, type of malignancy, treatment intent, need for early IMV, vasopressors, and dialysis in the ICU. How to cite this article:Sandill S, Mishra S, Garg R, Gupta N, Bharti SJ, Kumar V, et al. Outcomes of Cancer Patients Requiring Non-elective Medical Admission to the Intensive Care Unit of a Tertiary Care Center in India: A 5-year Retrospective Study. Indian J Crit Care Med 2026;30(1):13-18.
Aims:The aim of this study was to evaluate the impact of peroneus longus tendon (PLT) harvest on gait biomechanics following anterior cruciate ligament (ACL) reconstruction. There is scarce evidence in the literature about the safety of PLT as a potential graft for ACL reconstruction, and no long-term studies with gait assessment exist. We analyzed changes in spatiotemporal parameters (STPs) using a computerized gait analysis system and assessed functional ambulation over time. Methods:This prospective cohort study included 31 patients, including 23 males and eight females. The mean agewas 32.61 years (SD 10.60), with a mean clinical follow-up of 18.34 months (SD 6.25). The mean height, weight, and BMI were 160.23 cm (SD 8.08), 72.39 kg (SD 10.95), and 28.32 kg/m2 (SD 4.74), respectively. Gait analysis was performed preoperatively and postoperatively at six months and one year. Various STPs along with Functional Ambulation Profile (FAP) scores were assessed. Comparison of study variables between different time intervals was done using repeated measures analysis of variance followed by Bonferroni post-hoc test. A p-value < 0.05 was considered statistically significant. Results:Cadence, FAP score, single-leg support time, step time, and velocity increased significantly over different time intervals (p < 0.001). No significant difference in stride length, double support time, stance time, and swing time were noted over different time intervals. Conclusion:Despite overall improvements in functional gait, PLT harvest for ACL reconstruction resulted in subtle gait alterations, notably prolonged single-leg support time. Although compensatory mechanisms help to preserve gait function, these changes require careful consideration, particularly in athletes. Incorporating targeted ankle rehabilitation may help to reduce potential long-term effects. Further research is necessary to evaluate its impact on foot biomechanics and stability.
Osteoporosis and chronic bone pain (CBP) are prevalent complications in thalassemia, significantly affecting their quality of life. This study aimed to evaluate the efficacy of Denosumab in improving bone mineral density (BMD) and reducing CBP in thalassemic patients with osteoporosis. Single-arm interventional study. Twenty-three thalassemic patients with osteoporosis were enrolled. Dual-energy X-ray absorptiometry (DEXA) was performed at baseline and after two doses of Denosumab to assess T-scores/Z-scores and BMD at the lumbar spine (L1–L4) and left hip. Twelve patients received two additional doses and underwent repeat DEXA scans. Fracture history was recorded. CBP was evaluated using the Huskisson Visual Analog Scale (VAS) before treatment and after two and four doses for 23 and 12 patients, respectively. Statistical analysis was performed using the Wilcoxon signed-rank test, with p < 0.05 considered significant. Baseline median T-scores/Z-scores were−3.2 (L1–L4) and−2.6 (hip). After two doses, scores improved to−2.5 and−2.2, respectively (p < 0.001) with significant improvement in BMD. In 12 patients receiving four doses, scores improved further to−1.75 (L1–L4) and−2.0 (hip) from a median of−3.45 and−2.8 respectively with significant p-value. Among 14 patients reporting CBP, VAS scores declined from a median of 5.0 cm at baseline to 2.5 cm after two doses (p = 0.001). It further reduced to 2 cm after four doses in a subset of 12 patients (p = 0.017). Denosumab significantly improved BMD and reduced CBP in thalassemic patients with osteoporosis. These findings support its role as a promising therapeutic option in this population.
Despite advances in surgical techniques and implant design, a significant number of patients remain dissatisfied after total knee arthroplasty (TKA), often because of factors unrelated to the arthroplasty itself. Among these, pelvic biomechanics play a vital yet frequently overlooked role in affecting knee alignment, load distribution, and functional outcomes. This review explores how pelvic orientation, tilt, and dynamics, as well as coronal asymmetries and spinopelvic mobility, influence knee biomechanics and TKA planning. By viewing the pelvis not as a static reference but as a dynamic biomechanical driver, this study discusses how sagittal imbalance, pelvic obliquity, and stiffness impact intraoperative assessment and postoperative knee function. Using an integrated, evidence-based approach, the present study advocates for a paradigm shift in knee arthroplasty that recognises the pelvis as a central factor for success in TKA and promotes personalised solutions grounded in whole-body biomechanics.
