Outcome of hemato-oncologic patients with and without stem cell transplantation in a medical ICU.
OBJECTIVE
To assess the outcome of a mixed population of critical ill patients with haematological malignancies with special focus on the comparison of patients who underwent stem cell transplantation with non-transplanted patients.


METHODS
Retrospective, unicentric analysis of 94 critical ill cancer patients in a tertiary care centre in a period of two years time.


RESULTS
We analysed different variables at admission as well as different treatment modalities during the ICU stay. We compared the outcome by using chi-square test by Pearson for categorical variables and Kaplan-Meier as well as Cox-Regression for survival analysis. The general patients characteristics did not significantly differ between transplanted and non-transplanted patients. The overall ICU and hospital mortality were 43% and 54%. Considering just patients with mechanical ventilation we found ICU and hospital mortalities of 65% and 82% in the stem cell transplantation group vs. 67% and 74% in the non-transplanted group, respectively. As risk factors for overall mortality in multivariate analysis only the Simplified Acute Physiology Scale II and the need of ventilation remained significant. Between the underlying diseases mortality did not show significant differences at all.


CONCLUSIONS
The outcome and prognosis of critical ill cancer patients has generally slightly improved over the last years. Our data show no statistically significant differences regarding outcome and prognosis between stem cell transplanted and non-transplanted patients receiving ICU treatment. A stem cell transplantation should not be considered a strong contraindication for ICU treatment or artificial ventilation.
Bruennler
T
T
Department of Internal Medicine, University of Regensburg, Germany. tanja.bruennler@klinik.uni-r.de
Mandraka
F
F
Zierhut
S
S
Siebig
S
S
Wrede
C
C
Klebl
F
F
Holler
E
E
Salzberger
B
B
Schoelmerich
J
J
Langgartner
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate