Volume 19 Supplement 1

35th International Symposium on Intensive Care and Emergency Medicine

Open Access

Is admission of hematologic malignancies in the ICU justified?

  • VG Gasparovic1,
  • MM Grgic Medic1 and
  • IG Gornik1
Critical Care201519(Suppl 1):P538

https://doi.org/10.1186/cc14618

Published: 16 March 2015

Introduction

The admission of malignant hematology patients to the ICU is combined with poor prognosis [1]. A young population on one side and serious prognosis on the other are the main characteristics. Do we help? We are analyzing continuously clinical characteristics, treatment, and outcomes of critically ill patients with hematologic malignancies admitted to the medical ICU to identify predictors of adverse outcome [2].

Methods

Demographic characteristics, hematologic diagnosis, reasons for ICU admission, transplant status, the presence of neutropenia, and APACHE II and SOFA scores were analyzed. Predictors of ICU mortality were evaluated using univariate analysis.

Results

There was a total of 194 patients (103 male), APACHE II score by admission was 27 ± 8, SOFA 9 ± 3. Acute leukemia (L) in 81 patients (41.8%), chronic L in 19 patients (9.8%), lymphoma in 58 patients (29.9%), and multiple myeloma in 28 patients (14.4%) were the etiology. Respiratory insufficiency, hemodynamic instability, AKI and CNS disturbances were responsible for the admission of 169 patients (87.1%) from the hematology ward to the ICU. In total, 127 patients (59.7%) were mechanically ventilated; 93 required invasive mechanical ventilation (MV). Non-invasive ventilation started in 34 patients and was successful in 14 (6.5%). The ICU mortality rate was 104 patients (53.6%), and the mortality of MV patients was 98 (77.2%). Need for vasopressors at admission, MV, neutropenia, and APACHE II and SOFA scores were identified as independent predictors of fatal outcome. Overall mortality of admitted patients was 53.6% (104 patients), and in ventilated patients was 77.2% (98 patients).

Conclusion

The ICU mortality of critically ill patients with HM is high, particularly in the group on MV. Different factors were independent predictors of mortality, but 46.4% of admitted patients survived because of adequate support possibilities and were transferred back to hematology ward. The ICU admission with organ support is according

Results

important for life saving in this extremely high-risk patient group.

Authors’ Affiliations

(1)
KBC Zagreb

References

  1. Azoulay E, et al: The intensive care support of patients with malignancy: do everything that can be done. Intensive Care Med. 2006, 32: 3-5.View ArticlePubMedGoogle Scholar
  2. Grgic Medic M, et al: Hematologic malignancies in the medical intensive care unit - outcomes and prognostic factors. Hematology. 2014Google Scholar

Copyright

© Gasparovic et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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.

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