Skip to main content

Outcome of critically ill patients with haematological malignancy admitted to the ICU as an emergency

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

  1. 1.

    Cuthberson , et al.: The outcome of haematological malignancy in Scottish intensive care units. J Intensive Care Soc 2008, 9: 135-140.

    Article  Google Scholar 

  2. 2.

    Evison JM, et al.: Intensive care unit admission in patients with haematological disease: incidence, outcome and prognostic factors. Swiss Med Wkly 2001, 131: 681-688.

    CAS  PubMed  Google Scholar 

  3. 3.

    Beed , et al.: Intensive care management of patients with haematological malignancy. Conti Edu An Crit Care Pain 2010, 10: 167-171. 10.1093/bjaceaccp/mkq034

    Article  Google Scholar 

  4. 4.

    Kleber , et al.: Comorbidity as a prognostic variable in multiple myeloma: comparative evaluation of common comorbidity scores and use of a novel MM-comorbidity score. Blood Cancer J 2011, 1: e35. 10.1038/bcj.2011.34

    PubMed Central  Article  CAS  PubMed  Google Scholar 

  5. 5.

    McGrath S, et al.: ICU and 6-month outcome of oncology patients in the intensive care unit. QJM 2010, 103: 397-403. 10.1093/qjmed/hcq032

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to T Lofaro.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

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, P516 (2013). https://doi.org/10.1186/cc12454

Download citation

Keywords

  • Lymphoma
  • Myeloma
  • Bone Marrow Transplant
  • Marrow Transplant
  • Haematological Malignancy