Predictors of outcome in patients with hematologic malignancies admitted to the intensive care unit

Hematol Oncol Stem Cell Ther. 2018 Dec;11(4):206-218. doi: 10.1016/j.hemonc.2018.03.003. Epub 2018 Apr 17.

Abstract

Purpose: Several studies showed conflicting results about prognosis and predictors of outcome of critically ill patients with hematological malignancies (HM). The aim of this study is to determine the hospital outcome of critically ill patients with HM and the factors predicting the outcome.

Methods and materials: All patients with HM admitted to MICU at a tertiary academic medical center were enrolled. Clinical data upon admission and during ICU stay were collected. Hospital, ICU, and 6 months outcomes were documented.

Results: There were 130 HM patients during the study period. Acute Leukemia was the most common malignancy (31.5%) followed by Non-Hodgkin's Lymphoma (28.5%). About 12.5% patients had autologous HSCT and 51.5% had allogeneic HSCT. Sepsis was the most common ICU diagnosis (25.9%). ICU mortality and hospital mortality were 24.8% and 45.3%, respectively. Six months mortality (available on 80% of patients) was 56.7%. Hospital mortality was higher among mechanically ventilated patients (75%). Using multivariate analysis, only mechanical ventilation (OR of 19.0, CI: 3.1-117.4, P: 0.001) and allogeneic HSCT (OR of 10.9, CI: 1.8-66.9, P: 0.01) predicted hospital mortality.

Conclusion: Overall hospital outcome of critically ill patients with HM is improving. However those who require mechanical ventilation or underwent allogeneic HSCT continue to have poor outcome.

Publication types

  • Clinical Trial

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Allografts
  • Female
  • Hematologic Neoplasms / mortality*
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation
  • Hospital Mortality*
  • Humans
  • Intensive Care Units*
  • Leukemia / mortality*
  • Leukemia / pathology
  • Leukemia / therapy
  • Lymphoma, Non-Hodgkin / mortality*
  • Lymphoma, Non-Hodgkin / pathology
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Risk Factors
  • Sepsis / mortality*
  • Sepsis / pathology
  • Sepsis / therapy