Outcome and prognostic factors in patients with hematologic malignancies admitted to the intensive care unit: A single-center experience

Christelle Ferrà, Pilar Marcos, Maite Misis, Mireia Morgades, María Luisa Bordejé, Albert Oriol, Natalia Lloveras, Juan Manuel Sancho, Blanca Xicoy, Montserrat Batlle, Jordi Klamburg, Evarist Feliu, Josep Maria Ribera, José María Ribera Santasusana

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48 Citations (Scopus)

Abstract

Patients who are admitted to the intensive care unit (ICU) with hematologic malignancies have a poor prognosis, although outcomes have improved in recent years. This study analyzed ICU mortality, short- and long-term survival, and prognostic factors for 100 consecutive critically ill patients with a hematologic malignancy who were admitted to our polyvalent ICU from January 2000 to May 2006. The median age was 55 years (range, 15-75 years; male-female ratio, 60:40). The main acute life-threatening diseases precipitating ICU transfer were respiratory failure (45 patients, 45%) and septic shock (33 patients, 33%). Forty-two patients (42%) were discharged from the ICU. The ICU mortality rate from 2004 to 2006 was lower than from 2000 to 2003 (49% versus 69%, P < .047).The 1- and 2-year probabilities of survival for patients discharged from the ICU were 67% (95% confidence interval [CI], 51%-84%) and 54% (95% CI, 34%-73%), respectively. A multivariate analysis revealed hemodynamic instability (odds ratio, 2.11; 95% CI, 1.17-3.83; P = .014) and mechanical ventilation (odds ratio, 4.27; 95% CI, 1.70-10.74; P = .002) to be the main predictors of a poor survival prognosis. Almost half of patients with hematologic malignancy and life-threatening complications can be discharged from the ICU. Age and underlying disease characteristics do not influence ICU outcome, which is mainly determined by hemodynamic and ventilatory status. © 2007 The Japanese Society of Hematology.
Original languageEnglish
Pages (from-to)195-202
JournalInternational Journal of Hematology
Volume85
Issue number3
DOIs
Publication statusPublished - 1 Apr 2007

Keywords

  • Critical care
  • Hematologic malignancy
  • Leukemia
  • Lymphoma
  • Prognosis

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