Astrid M P Demandt1, Daniël A Geerse2, Bram J P Janssen3, Bjorn Winkens4, Harry C Schouten1, Walther N K A van Mook5. 1. Division of Hematology, Department of Internal Medicine, GROW, Maastricht University Medical Center, Maastricht, The Netherlands. 2. Division of Nephrology, Department of Internal Medicine, Bravis Hospital, Roosendaal, The Netherlands. 3. Department of Anaesthesiology, University Medical Center Groningen, Groningen, The Netherlands. 4. Department of Methodology and Statistics, CAPHRI, Maastricht University, Maastricht, The Netherlands. 5. Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Abstract
BACKGROUND: Patients with hematological malignancies admitted to an intensive care unit (ICU) have a poor prognosis. The Sequential Organ Failure Assessment (SOFA) score is used to monitor patients on the ICU. Little is known about the value of this score in hematology patients. Therefore, the prognostic value of the SOFA score and a modified hematological SOFA score (SOFAhem) was studied. METHODS: Patients with hematological malignancies admitted to the ICU between 1999 and 2009 were analyzed in a retrospective cohort study. The SOFAhem score was defined as the original SOFA score omitting the coagulation and neurological parameters. RESULTS: In 149 admissions, ICU mortality was 52%. Mortality was significantly associated with higher SOFA and SOFAhem scores on admission, and trend in SOFAhem scores. An unchanged and increased SOFAhem score compared to decreasing SOFAhem scores was associated with a higher mortality rate (53% resp 67% resp 25%). CONCLUSIONS: Trends in SOFA or SOFAhem score are both suitable as prognostic parameter. The trend in SOFAhem score seems to be independently related to mortality in hematological patients admitted to the ICU, and because of the higher odds ratios and lower P-values compared to the SOFA score, it is probably stronger related to mortality than the classical score, but its prognostic value should be tested in a larger cohort.
BACKGROUND:Patients with hematological malignancies admitted to an intensive care unit (ICU) have a poor prognosis. The Sequential Organ Failure Assessment (SOFA) score is used to monitor patients on the ICU. Little is known about the value of this score in hematology patients. Therefore, the prognostic value of the SOFA score and a modified hematological SOFA score (SOFAhem) was studied. METHODS:Patients with hematological malignancies admitted to the ICU between 1999 and 2009 were analyzed in a retrospective cohort study. The SOFAhem score was defined as the original SOFA score omitting the coagulation and neurological parameters. RESULTS: In 149 admissions, ICU mortality was 52%. Mortality was significantly associated with higher SOFA and SOFAhem scores on admission, and trend in SOFAhem scores. An unchanged and increased SOFAhem score compared to decreasing SOFAhem scores was associated with a higher mortality rate (53% resp 67% resp 25%). CONCLUSIONS: Trends in SOFA or SOFAhem score are both suitable as prognostic parameter. The trend in SOFAhem score seems to be independently related to mortality in hematological patients admitted to the ICU, and because of the higher odds ratios and lower P-values compared to the SOFA score, it is probably stronger related to mortality than the classical score, but its prognostic value should be tested in a larger cohort.
Authors: Lucie Probst; Enrico Schalk; Tobias Liebregts; Vanja Zeremski; Asterios Tzalavras; Michael von Bergwelt-Baildon; Nina Hesse; Johanna Prinz; Jörg Janne Vehreschild; Alexander Shimabukuro-Vornhagen; Dennis A Eichenauer; Jorge Garcia Borrega; Matthias Kochanek; Boris Böll Journal: J Intensive Care Date: 2019-08-07
Authors: Gabriel Piñeiro Telles; Isabella Bonifácio Brige Ferreira; Rodrigo Carvalho de Menezes; Thomas Azevedo do Carmo; Paula Lins David Pugas; Lara Freitas Marback; Maria B Arriaga; Kiyoshi F Fukutani; Licurgo Pamplona Neto; Sydney Agareno; Kevan M Akrami; Nivaldo Menezes Filgueiras Filho; Bruno B Andrade Journal: PLoS One Date: 2020-02-21 Impact factor: 3.240