Intensive care unit outcomes in patients with hematological malignancy

Area of Science:

• Hematology
• Oncology
• Critical Care Medicine

Background:

• Hematological malignancies are life-limiting conditions requiring early care limitation decisions.
• Inappropriate intensive care unit (ICU) admission burdens patients, families, and healthcare systems.
• Limited data exists on pre-ICU admission factors influencing outcomes in hematological malignancy.

Purpose of the Study:

• To identify baseline and disease-associated factors before ICU admission in hematological malignancy patients.
• To determine factors contributing to subsequent ICU mortality in this patient group.

Main Methods:

• Retrospective analysis of 184 hematological malignancy patients admitted to ICU from 2013-2017.
• Comparison of baseline data (age, gender, Eastern Cooperative Oncology Group performance status, Charlson Comorbidity Score) with ICU outcomes and survival.
• Evaluation of disease-specific prognostic risk scores against ICU outcomes.

Main Results:

• 73.9% of patients survived ICU admission; 31.6% survived at 12 months.
• Superior ejection fraction (>55%) and >12 months prognosis were associated with overall survival (P=0.024, P=0.001).
• Induction/post-transplantation therapy predicted poor ICU survival (P<0.0001, P=0.041); APACHE scores predicted ICU mortality (P=0.002-P<0.0001).

Conclusions:

• ICU survival in hematological malignancy patients correlates with functional and comorbidity status.
• Disease-specific prognostic scores aid in identifying patients who may benefit from ICU admission.