Time trend analysis of long term outcome of patients with haematological malignancies admitted at dutch intensive care units.

Autor: de Vries VA; Department of Critical Care, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Müller MCA; Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands., Sesmu Arbous M; Department of Intensive Care Medicine, Leiden University Medical Centre, Leiden, The Netherlands., Biemond BJ; Department of Haematology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands., Blijlevens NMA; Department of Haematology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands., Kusadasi N; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.; University Medical Centre Utrecht, Utrecht, The Netherlands., Choi GCW; Department of Haematology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Vlaar APJ; Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands., van Westerloo DJ; Department of Intensive Care Medicine, Leiden University Medical Centre, Leiden, The Netherlands., Kluin-Nelemans HC; Department of Haematology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., van den Bergh WM; Department of Critical Care, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2018 Apr; Vol. 181 (1), pp. 68-76. Date of Electronic Publication: 2018 Feb 22.
DOI: 10.1111/bjh.15140
Abstrakt: A few decades ago, the chances of survival for patients with a haematological malignancy needing Intensive Care Unit (ICU) support were minimal. As a consequence, ICU admission policy was cautious. We hypothesized that the long-term outcome of patients with a haematological malignancy admitted to the ICU has improved in recent years. Furthermore, our objective was to evaluate the predictive value of the Acute Physiology and Chronic Health Evaluation (APACHE) II score. A total of 1095 patients from 5 Dutch university hospitals were included from 2003 until 2015. We studied the prevalence of patients' characteristics over time. By using annual odds ratios, we analysed which patients' characteristics could have had influenced possible trends in time. A approximated mortality rate was compared with the ICU mortality rate, to study the predictive value of the APACHE II score. Overall one-year mortality was 62%. The annual decrease in one-year mortality was 7%, whereas the APACHE II score increased over time. Decreased mortality rates were particularly observed in high-risk patients (acute myeloid leukaemia, old age, low platelet count, bleeding as admission reason and need for mechanical ventilation within 24 h of ICU admission). Furthermore, the APACHE II score overestimates mortality in this patient category.
(© 2018 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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