Intensive care unit admission in patients with hematological disease: incidence, outcome and prognostic factors
| Autor: | J. M. Evison, Jakob Passweg, P. Rickenbacher, S. Elsasser, Ch. HABERTHüR, Alois Gratwohl, Rudolf Ritz |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Care Multiple Organ Failure medicine.medical_treatment Statistics as Topic law.invention Cohort Studies law Internal medicine medicine Humans Child Intensive care medicine Aged Retrospective Studies Mechanical ventilation Septic shock business.industry Incidence (epidemiology) Retrospective cohort study General Medicine Prognosis medicine.disease Survival Analysis Intensive care unit Hospitalization Transplantation Treatment Outcome Respiratory failure Hematologic Neoplasms Female business Cohort study |
| Zdroj: | Swiss Medical Weekly. |
| ISSN: | 1424-3997 |
| DOI: | 10.4414/smw.2001.09801 |
| Popis: | To examine incidence and outcome of intensive care unit (ICU) admission in patients with haematological malignancy and analyse prognostic factors associated with outcome.Retrospective cohort study in an intensive care unit of a tertiary referral center.78 patients with severe haematological malignancy were admitted 97 times between 1990-97 to the medical ICU for septic shock (18), respiratory failure (30), postoperative monitoring (19), cardiovascular (10) and central nervous complications (8) or for other reasons (12). Median age was 43 (4-73) years, average duration of ICU stay was 4 (1-43) days. Forty-two patients required mechanical ventilation, 46 vasopressors and 8 haemodialysis.Rates of ICU admission differed by treatment of the underlying disease. There were 18, 10 and 27 ICU admissions per 100 treatments in patients undergoing chemotherapy for acute leukaemia, autologous and allogeneic stem cell transplantation (p0.005) respectively. Thirty-two of 78 patients died within 60 days of ICU admission. Organ failure, i.e. cardiovascular failure requiring vasopressors, respiratory failure requiring mechanical ventilation and renal failure, requiring haemodialysis, was most significantly associated with outcome. Mortality by day 60 after admission was 16%, 36%, 64%, and 83% (p0.0002) for patients without organ failure, and for patients with 1, 2 or 3 failing organs. In a multivariate logistical regression model, only the organ failure score (p0.0005) and evidence of liver damage, defined as ASAT or ALAT100 IU/ L (p0.007), but not age, sex, primary disease and treatment of the underlying disease predicted outcome.Multi-organ failure and evidence of liver damage but no other patient, disease, or treatment related factor predict outcome in patients with haematological disease admitted to the ICU. |
| Databáze: | OpenAIRE |
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