title: Mortality of patients with hematological malignancy after admission to the intensive care unit.
abstract: BACKGROUND
  The admission of patients with malignancies to an intensive care unit (ICU) still remains a matter of substantial controversy. The identification of factors that potentially influence the patient outcome can help ICU professionals make appropriate decisions.
  
  
  METHODS
  90 adult patients with hematological malignancy (leukemia 47.8%, high-grade lymphoma 50%) admitted to the ICU were analyzed retrospectively in this single-center study considering numerous variables with regard to their influence on ICU and day-100 mortality.
  
  
  RESULTS
  The median simplified acute physiology score (SAPS) II at ICU admission was 55 (ICU survivors 47 vs. 60.5 for non-survivors). The overall ICU mortality rate was 45.6%. With multivariate regression analysis, patients admitted with sepsis and acute respiratory failure had a significantly increased ICU mortality (sepsis odds ratio (OR) 9.12, 95% confidence interval (CI) 1.1- 99.7, p = 0.04; respiratory failure OR 13.72, 95% CI 1.39-136.15, p = 0.025). Additional factors associated with an increased mortality were: high doses of catecholamines (ICU: OR 7.37, p = 0.005; day 100: hazard ratio (HR) 2.96, p < 0.0001), renal replacement therapy (day 100: HR 1.93, p = 0.026), and high SAPS II (ICU: HR 1.05, p = 0.038; day 100: HR 1.2, p = 0.027).
  
  
  CONCLUSIONS
  The decision for or against ICU admission of patients with hematological diseases should become increasingly independent of the underlying malignant disease.
authors.affiliation: Medical Department II, Intensive Care Unit, Ludwig Maximilian University of Munich, Campus Großhadern, Munich, Germany.
authors.forename: Sophia
authors.initials: S
authors.lastname: Horster
authors.forename: H Joachim
authors.initials: HJ
authors.lastname: Stemmler
authors.forename: Philipp C
authors.initials: PC
authors.lastname: Mandel
authors.forename: Alexander
authors.initials: A
authors.lastname: Mück
authors.forename: Johanna
authors.initials: J
authors.lastname: Tischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Hausmann
authors.forename: Klaus G
authors.initials: KG
authors.lastname: Parhofer
authors.forename: Sandra
authors.initials: S
authors.lastname: Geiger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate