PURPOSE: To explore trends over time in admission prevalence and (risk-adjusted) mortality of critically ill haematological patients and compare these trends to those of several subgroups of patients admitted to the medical intensive care unit (medical ICU patients). METHODS: A total of 1,741 haematological and 60,954 non-haematological patients admitted to the medical ICU were analysed. Trends over time and differences between two subgroups of haematological medical ICU patients and four subgroups of non-haematological medical ICU patients were assessed, as well as the influence of leukocytopenia. RESULTS: The proportion of haematological patients among all medical ICU patients increased over time [odds ratio (OR) 1.06; 95 % confidence interval (CI) 1.03-1.10 per year; p < 0.001]. Risk-adjusted mortality was significantly higher for haematological patients admitted to the ICU with white blood cell (WBC) counts of <1.0 × 10(9)/L (47 %; 95 % CI 41-54 %) and ≥1.0 × 10(9)/L (45 %; 95 % CI 42-49 %), respectively, than for patients admitted with chronic heart failure (27 %; 95 % CI 26-28 %) and with chronic liver cirrhosis (38 %; 95 % CI 35-42 %), but was not significantly different from patients admitted with solid tumours (40 %; 95 % CI 36-45 %). Over the years, the risk-adjusted hospital mortality rate significantly decreased in both the haematological and non-haematological group with an OR of 0.93 (95 % CI 0.92-0.95) per year. After correction for case-mix using the APACHE-II score (with WBC omitted), a WBC <1.0 × 10(9)/L was not a predictor of mortality in haematological patients (OR 0.86; 95 % CI 0.46-1.64; p = 0.65). We found no case-volume effect on mortality for haematological ICU patients. CONCLUSIONS: An increasing number of haematological patients are being admitted to Dutch ICUs. While mortality is significantly higher in this group of medical ICU patients than in subgroups of non-haematological ones, the former show a similar decrease in raw and risk-adjusted mortality rate over time, while leukocytopenia is not a predictor of mortality. These results suggest that haematological ICU patients have benefitted from improved intensive care support during the last decade.
PURPOSE: To explore trends over time in admission prevalence and (risk-adjusted) mortality of critically ill haematological patients and compare these trends to those of several subgroups of patients admitted to the medical intensive care unit (medical ICU patients). METHODS: A total of 1,741 haematological and 60,954 non-haematological patients admitted to the medical ICU were analysed. Trends over time and differences between two subgroups of haematological medical ICU patients and four subgroups of non-haematological medical ICU patients were assessed, as well as the influence of leukocytopenia. RESULTS: The proportion of haematological patients among all medical ICU patients increased over time [odds ratio (OR) 1.06; 95 % confidence interval (CI) 1.03-1.10 per year; p < 0.001]. Risk-adjusted mortality was significantly higher for haematological patients admitted to the ICU with white blood cell (WBC) counts of <1.0 × 10(9)/L (47 %; 95 % CI 41-54 %) and ≥1.0 × 10(9)/L (45 %; 95 % CI 42-49 %), respectively, than for patients admitted with chronic heart failure (27 %; 95 % CI 26-28 %) and with chronic liver cirrhosis (38 %; 95 % CI 35-42 %), but was not significantly different from patients admitted with solid tumours (40 %; 95 % CI 36-45 %). Over the years, the risk-adjusted hospital mortality rate significantly decreased in both the haematological and non-haematological group with an OR of 0.93 (95 % CI 0.92-0.95) per year. After correction for case-mix using the APACHE-II score (with WBC omitted), a WBC <1.0 × 10(9)/L was not a predictor of mortality in haematological patients (OR 0.86; 95 % CI 0.46-1.64; p = 0.65). We found no case-volume effect on mortality for haematological ICU patients. CONCLUSIONS: An increasing number of haematological patients are being admitted to Dutch ICUs. While mortality is significantly higher in this group of medical ICU patients than in subgroups of non-haematological ones, the former show a similar decrease in raw and risk-adjusted mortality rate over time, while leukocytopenia is not a predictor of mortality. These results suggest that haematological ICU patients have benefitted from improved intensive care support during the last decade.
Authors: Peter Schellongowski; Thomas Staudinger; Michael Kundi; Klaus Laczika; Gottfried J Locker; Andja Bojic; Oliver Robak; Valentin Fuhrmann; Ulrich Jäger; Peter Valent; Wolfgang R Sperr Journal: Haematologica Date: 2010-11-11 Impact factor: 9.941
Authors: Silvio A Namendys-Silva; María O González-Herrera; Francisco J García-Guillén; Julia Texcocano-Becerra; Angel Herrera-Gómez Journal: Ann Hematol Date: 2013-01-18 Impact factor: 3.673
Authors: Ted A Gooley; Jason W Chien; Steven A Pergam; Sangeeta Hingorani; Mohamed L Sorror; Michael Boeckh; Paul J Martin; Brenda M Sandmaier; Kieren A Marr; Frederick R Appelbaum; Rainer Storb; George B McDonald Journal: N Engl J Med Date: 2010-11-25 Impact factor: 91.245
Authors: Paul B Massion; Alain M Dive; Chantal Doyen; Pierre Bulpa; Jacques Jamart; André Bosly; Etienne Installé Journal: Crit Care Med Date: 2002-10 Impact factor: 7.598
Authors: Massimo Antonelli; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; J Randall Curtis; Daniel De Backer; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Patricia Rocco; Jean-François Timsit; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2012-01-20 Impact factor: 17.440
Authors: William M Townsend; Ailsa Holroyd; Rachel Pearce; Stephen Mackinnon; Prakesh Naik; Anthony H Goldstone; David C Linch; Karl S Peggs; Kirsty J Thomson; Mervyn Singer; David C J Howell; Emma C Morris Journal: Br J Haematol Date: 2013-03-18 Impact factor: 6.998
Authors: Peter H Asdahl; Steffen Christensen; Anders Kjærsgaard; Christian F Christiansen; Peter Kamper Journal: Intensive Care Med Date: 2020-01-29 Impact factor: 17.440
Authors: Samuel D Slavin; Alyssa Fenech; Amanda L Jankowski; Gregory A Abel; Andrew M Brunner; David P Steensma; Amir T Fathi; Daniel J DeAngelo; Martha Wadleigh; Gabriela S Hobbs; Philip C Amrein; Richard M Stone; Jennifer S Temel; Areej El-Jawahri Journal: Cancer Date: 2019-07-12 Impact factor: 6.860
Authors: Patrick G Lyons; Jeff Klaus; Colleen A McEvoy; Peter Westervelt; Brian F Gage; Marin H Kollef Journal: J Oncol Pract Date: 2019-07-15 Impact factor: 3.840
Authors: Elie Azoulay; Peter Schellongowski; Michael Darmon; Philippe R Bauer; Dominique Benoit; Pieter Depuydt; Jigeeshu V Divatia; Virginie Lemiale; Maarten van Vliet; Anne-Pascale Meert; Djamel Mokart; Stephen M Pastores; Anders Perner; Frédéric Pène; Peter Pickkers; Kathryn A Puxty; Francois Vincent; Jorge Salluh; Ayman O Soubani; Massimo Antonelli; Thomas Staudinger; Michael von Bergwelt-Baildon; Marcio Soares Journal: Intensive Care Med Date: 2017-07-19 Impact factor: 17.440