title: The sepsis-related Organ Failure Assessment (SOFA) score is predictive for survival of patients admitted to the intensive care unit following allogeneic blood stem cell transplantation.
abstract: Intensive care unit (ICU) support following allogeneic peripheral blood stem cell transplantation (PBSCT) is controversial due to the limited prognosis of these patients in case of secondary critical illness. In this retrospective single centre study, we looked for factors predicting survival in patients who needed ICU support after myeloablative (MAC) or non-myeloablative conditioning (non-MAC) therapy and allogeneic PBSCT. Between 1999 and 2006, 64 out of 319 patients following allogeneic PBSCT were admitted to the ICU (24 female and 40 male patients, median age 47 years, range 17-65 years; MAC 49 patients, non-MAC 15 patients). All 64 patients required mechanical ventilation. We looked for variables defining the Sepsis-related Organ Failure Assessment (SOFA) score as well as for baseline characteristics and transplant-associated parameters on the day of ICU admission possibly predictive for poor or good survival prognosis. Nineteen of 49 patients who had received MAC therapy survived the ICU stay for a median time of 9 months (range 2-29 months) and three of 15 patients who had received non-MAC therapy could be discharged from the ICU with a survival time of 4, 5 and 12 months. After univariate and multivariate analysis the SOFA score discriminated survivors and non-survivors of the ICU stay. We conclude that the SOFA score is predictive for survival when applied on the day of ICU admission.
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. Frank.Neumann@med.uni-duesseldorf.de
authors.forename: Frank
authors.initials: F
authors.lastname: Neumann
authors.forename: Oliver
authors.initials: O
authors.lastname: Lobitz
authors.forename: Roland
authors.initials: R
authors.lastname: Fenk
authors.forename: Ingmar
authors.initials: I
authors.lastname: Bruns
authors.forename: Matthias
authors.initials: M
authors.lastname: Köstering
authors.forename: Stefan
authors.initials: S
authors.lastname: Steiner
authors.forename: Marcus
authors.initials: M
authors.lastname: Hennersdorf
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Bodo Eckehard
authors.initials: BE
authors.lastname: Strauer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
authors.forename: Axel
authors.initials: A
authors.lastname: Hinke
authors.forename: Rainer
authors.initials: R
authors.lastname: Haas
authors.forename: Guido
authors.initials: G
authors.lastname: Kobbe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology*; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D016019:Survival Analysis; D017741:Survivors; D014184:Transplantation, Homologous; D017211:Treatment Failure