Bridging Haemato-Oncology and Critical Care: Survival and Functional Outcomes From a Portuguese Central Hospital

Background  Despite substantial therapeutic progress in haemato-oncology (HO), referring exclusively to patients with haematological malignancies, ICU admission decisions for these patients are often hindered by the perception of poor prognosis. This study aimed to evaluate the one-year survival and functional outcomes of critically ill HO patients following hospital discharge. Methods  A retrospective, single-centre observational study was conducted in a Portuguese tertiary care centre, including 54 consecutive non-elective ICU admissions of adult HO patients between January 2022 and October 2023. The primary endpoint was one-year survival post-hospital discharge, while secondary endpoints included maintenance of treatment plans and functional recovery assessed using the Eastern Cooperative Oncology Group (ECOG) performance status one year after hospital discharge. Results  Seventy-four percent of patients survived their ICU stay, with survival rates of 61% at six months and 50% at one year post-discharge. Among one-year survivors, 93% exhibited good performance status (ECOG 0-1) and continued their intended oncological treatment. Only 7% transitioned to palliative care. Despite a high burden of organ dysfunction (87% with multiple dysfunctions) and significant therapeutic needs, including mechanical ventilation (33%) and renal replacement therapy (50%), functional recovery and treatment resumption were achieved in most survivors. Conclusions  Critically ill HO patients can achieve meaningful survival and functional recovery following ICU admission. The findings challenge prior biases against ICU admissions for this population and underscore the need for early, multidisciplinary intervention to optimize outcomes.