Abstract
Introduction: Patients with hematological malignancies who develop severe pulmonary complications and require admission to ICU have a poor hospital outcome.We studied etiology, outcome and prognostic factors in respiratory critically-ill patients with hematological malignancies admitted to ICU.
Methods: A retrospective cohort study in an 8-bed medical ICU of a university hospital. 105 critically-ill patients with hematological malignancies and pulmonary complications treated within a 10 year period were included. Were analyzed, patients clinical characteristics and outcome. Multivariate analysis was performed to identify prognostic factors.
Results: The underlying malignancies were predominantly acute leukaemia, 67% ; non-Hodgkin lymphoma, 19% ; Hodgkin lymphoma, 5.8% ; myelodysplasia syndrome, 6.7% and multiple myeloma, 1.9%.Length of stay in the ICU was 4.77±6.14 days. All were ventilated (84%, invasive ventilation and 16%,NIV). Overall ICU mortality was 73.3%, with significantly higher mortality in invasive-ventilated patients (74%)vsNIV patients(12%), p<0.001. Mean SAPSII score was 47.35±15.57.The etiology of acute respiratory failure was infectious diseases in 79(75%).Patients with neutropenia,(53.3%). Septic shock,(38.1%).Multivariate analysis identified SAPSII score, catecholamine use in the first 24-hours andventilatory support immediately prior to, or at admission to the ICU as independent prognostic factors of ICU mortality.
Conclusion: The outcome of respiratory critically-ill patients with hematological malignancies was overall poor. SAPSII, catecholamine use and mechanical ventilation revealed independent prognostic factors.
- Copyright ©ERS 2015