BACKGROUND: The prognosis of patients with haematological malignancies who are admitted to the ICU is generally poor. In order to optimize care, it is important to be able to determine which patients are most likely to benefit from continuation of treatment after ICU admission. METHODS: Data of 86 patients with a haematological malignancy consecutively admitted to the ICU of Maastricht University Medical Centre were examined in a retrospective cohort study in order to identify clinically useful prognostic parameters. RESULTS: ICU mortality was 56% and in-hospital mortality was 65%. Non-survivors had higher APACHE-II and SOFA scores compared with survivors (32±8.0 versus 25±6.5 and 11.5±3.1 versus 8.5±3.0, respectively). The mortality rate was significantly higher in patients with an increasing SOFA score (≥2 points) compared with patients with an unchanged or decreasing SOFA score (72% versus 58% and 21%, respectively). Mortality was also higher in patients requiring invasive mechanical ventilation or inotropic/vasopressor therapy. CONCLUSION: The mortality rate among patients with haematological malignancies who are admitted to the ICU is high and mainly associated with the severity of illness, as reflected by more severe and worsening organ failure and a need for mechanical ventilation or inotropic/vasopressor therapy. Several factors appear to be associated with a poor outcome, but no absolute predictors of mortality could be identified, although the results suggest that changes in the SOFA score during the stay in the ICU can be helpful in the decision making about the continuation or discontinuation of treatment.
BACKGROUND: The prognosis of patients with haematological malignancies who are admitted to the ICU is generally poor. In order to optimize care, it is important to be able to determine which patients are most likely to benefit from continuation of treatment after ICU admission. METHODS: Data of 86 patients with a haematological malignancy consecutively admitted to the ICU of Maastricht University Medical Centre were examined in a retrospective cohort study in order to identify clinically useful prognostic parameters. RESULTS: ICU mortality was 56% and in-hospital mortality was 65%. Non-survivors had higher APACHE-II and SOFA scores compared with survivors (32±8.0 versus 25±6.5 and 11.5±3.1 versus 8.5±3.0, respectively). The mortality rate was significantly higher in patients with an increasing SOFA score (≥2 points) compared with patients with an unchanged or decreasing SOFA score (72% versus 58% and 21%, respectively). Mortality was also higher in patients requiring invasive mechanical ventilation or inotropic/vasopressor therapy. CONCLUSION: The mortality rate among patients with haematological malignancies who are admitted to the ICU is high and mainly associated with the severity of illness, as reflected by more severe and worsening organ failure and a need for mechanical ventilation or inotropic/vasopressor therapy. Several factors appear to be associated with a poor outcome, but no absolute predictors of mortality could be identified, although the results suggest that changes in the SOFA score during the stay in the ICU can be helpful in the decision making about the continuation or discontinuation of treatment.
Authors: Rohan Gupta; Neda Heshami; Chouhan Jay; Naveen Ramesh; Juhee Song; Xiudong Lei; Erfe Jean Rose; Kristen Carter; Dejka M Araujo; Robert S Benjamin; Shreyaskumar Patel; Joseph L Nates; Vinod Ravi Journal: Clin Sarcoma Res Date: 2016-07-19
Authors: Michele Pohlen; Nils H Thoennissen; Jan Braess; Johannes Thudium; Christoph Schmid; Matthias Kochanek; Karl-Anton Kreuzer; Pia Lebiedz; Dennis Görlich; Hans U Gerth; Christian Rohde; Torsten Kessler; Carsten Müller-Tidow; Matthias Stelljes; Carsten Hullermann; Thomas Büchner; Günter Schlimok; Michael Hallek; Johannes Waltenberger; Wolfgang Hiddemann; Wolfgang E Berdel; Bernhard Heilmeier; Utz Krug Journal: PLoS One Date: 2016-08-30 Impact factor: 3.240