I Suárez1, B Böll1,2, A Shimabukuro-Vornhagen1,2, G Michels3, M von Bergwelt-Baildon1,2, M Kochanek4,5. 1. Klinik I für Innere Medizin, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland. 2. Arbeitskreis iCHOP (Intensive Care in Hemato-Oncologic Patients) in der DGIIN, DGHO, FASIM, Köln, Deutschland. 3. Klinik III für Innere Medizin, Universitätsklinik Köln, Köln, Deutschland. 4. Klinik I für Innere Medizin, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland. matthias.kochanek@uk-koeln.de. 5. Arbeitskreis iCHOP (Intensive Care in Hemato-Oncologic Patients) in der DGIIN, DGHO, FASIM, Köln, Deutschland. matthias.kochanek@uk-koeln.de.
Abstract
BACKGROUND: Febrile neutropenia remains one of the most common reasons for hospital admission of patients with underlying oncologic disease. These patients have an up to 10-fold increased risk of developing sepsis, which often leads to these patients being transferred to the intensive care unit (ICU). The survival of neutropenic patients with sepsis in particular has improved in recent years, due to advanced therapy in intensive care (surviving sepsis campaign); however few large international studies of neutropenic cancer patients in the ICU are available. METHODS: In a retrospective study, 59 episodes of neutropenic cancer patients in the internal medicine ICU at the University Hospital of Cologne over a period of 2 years were analyzed. RESULTS: Pneumonia with or without sepsis are the main admission diagnoses of neutropenic cancer patients in the ICU. The mortality rate of these patients is very high (50.8 %). Pneumonia and sepsis, stem cell transplantation, mechanical ventilation, and acute renal failure with or without dialysis are correlated with mortality. CONCLUSION: Cancer patients should be admitted immediately to the ICU if they have signs of sepsis for early monitoring and treatment. Neutropenic patients have an increased risk for infectious complications and a risk for sepsis with higher mortality rates.
BACKGROUND:Febrile neutropenia remains one of the most common reasons for hospital admission of patients with underlying oncologic disease. These patients have an up to 10-fold increased risk of developing sepsis, which often leads to these patients being transferred to the intensive care unit (ICU). The survival of neutropenicpatients with sepsis in particular has improved in recent years, due to advanced therapy in intensive care (surviving sepsis campaign); however few large international studies of neutropenic cancerpatients in the ICU are available. METHODS: In a retrospective study, 59 episodes of neutropenic cancerpatients in the internal medicine ICU at the University Hospital of Cologne over a period of 2 years were analyzed. RESULTS: Pneumonia with or without sepsis are the main admission diagnoses of neutropenic cancerpatients in the ICU. The mortality rate of these patients is very high (50.8 %). Pneumonia and sepsis, stem cell transplantation, mechanical ventilation, and acute renal failure with or without dialysis are correlated with mortality. CONCLUSION:Cancerpatients should be admitted immediately to the ICU if they have signs of sepsis for early monitoring and treatment. Neutropenicpatients have an increased risk for infectious complications and a risk for sepsis with higher mortality rates.
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Crit Care Med Date: 2003-04 Impact factor: 7.598
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