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Outcome and Prognostic Factors in Patients with Hematologic Malignancies Admitted to the Intensive Care Unit: A Single-Center Experience

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Abstract

Patients who are admitted to the intensive care unit (ICU) with hematologic malignancies have a poor prognosis, although outcomes have improved in recent years. This study analyzed ICU mortality, short- and long-term survival, and prognostic factors for 100 consecutive critically ill patients with a hematologic malignancy who were admitted to our polyvalent ICU from January 2000 to May 2006. The median age was 55 years (range, 15-75 years; male-female ratio, 60:40). The main acute life-threatening diseases precipitating ICU transfer were respiratory failure (45 patients, 45%) and septic shock (33 patients, 33%). Forty-two patients (42%) were discharged from the ICU.The ICU mortality rate from 2004 to 2006 was lower than from 2000 to 2003 (49% versus 69%,P < .047).The 1- and 2-year probabilities of survival for patients discharged from the ICU were 67% (95% confidence interval [CI], 51%-84%) and 54% (95% CI, 34%-73%), respectively. A multivariate analysis revealed hemodynamic instability (odds ratio, 2.11; 95% CI, 1.17-3.83;P = .014) and mechanical ventilation (odds ratio, 4.27; 95% CI, 1.70-10.74;P = .002) to be the main predictors of a poor survival prognosis. Almost half of patients with hematologic malignancy and life-threatening complications can be discharged from the ICU. Age and underlying disease characteristics do not influence ICU outcome, which is mainly determined by hemodynamic and ventilatory status.

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Authors and Affiliations

  1. Clinical Hematology Department, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona, 08916, Spain

    Christelle Ferrà, Mireia Morgades, Albert Oriol, Natalia Lloveras, Juan-Manuel Sancho, Blanca Xicoy, Montserrat Batlle, Jordi Klamburg, Evarist Feliu & Josep-Maria Ribera

  2. Intensive Care Department, Hospital Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona, Spain

    Pilar Marcos, Maite Misis & María-Luisa Bordejé

Authors
  1. Christelle Ferrà
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  2. Pilar Marcos
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  3. Maite Misis
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  4. Mireia Morgades
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  5. María-Luisa Bordejé
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  6. Albert Oriol
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  7. Natalia Lloveras
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  13. Josep-Maria Ribera
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Correspondence to Josep-Maria Ribera.

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Ferrà, C., Marcos, P., Misis, M. et al. Outcome and Prognostic Factors in Patients with Hematologic Malignancies Admitted to the Intensive Care Unit: A Single-Center Experience. Int J Hematol 85, 195–202 (2007). https://doi.org/10.1532/IJH97.E0625

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  • DOI: https://doi.org/10.1532/IJH97.E0625

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