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Outcome of critically ill patients with haematological malignancy admitted to the ICU as an emergency
Critical Care volume 17, Article number: P516 (2013)
Introduction
ICU admission policies regarding patients with haemato-logical malignancy still vary despite data showing an acceptable prognosis. Our aim was to review ICU and 6-month outcomes in this group when requiring emergency admission to the ICU in a tertiary cancer centre.
Methods
A retrospective review of medical notes between 2004 and 2012.
Results
A total of 249 patients were admitted, of whom 54 had more than one admission. There were 310 episodes in total. Leukaemia n = 85; lymphoma n = 90; myeloma n = 36. We compared the characteristics of those who survived ICU admission with those who failed to survive to discharge from ICU. The two populations were similar (age 51 vs. 57; males 59% vs. 57%). Those who survived had a lower APACHE II score on admission (19 vs. 23; P 0.001), lower mean organ failure scores (1 vs. 2; P 0.05), lower requirements of inotropes (26% vs. 50%; P = 0.001), ventilation (31% vs. 64%; P = 0.001) and filtration (11% vs. 26%; P = 0.004). There was no difference in the prevalence of sepsis at the time of admission (64% vs. 70%). Both groups included patients with prior bone marrow transplant (38% vs. 40%). Of note, ICU and 6-month survival were 27% and 50%, respectively. These values are lower than those reported in the literature to date.
Conclusion
ICU and 6-month mortalities were 27% and 50%, respectively. Patients with haematological malignancy stand to benefit from intensive care, and should be offered admission based on clinical need.
References
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Lofaro, T., Easdale, S., Rowe, S. et al. Outcome of critically ill patients with haematological malignancy admitted to the ICU as an emergency. Crit Care 17 (Suppl 2), P516 (2013). https://doi.org/10.1186/cc12454
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DOI: https://doi.org/10.1186/cc12454