title: Prognostic factors in critically ill patients with hematologic malignancies admitted to the intensive care unit.
abstract: OBJECTIVE
  Despite an improvement in the prognosis of patients with hematologic malignancies, the mortality of such patients transferred to the intensive care unit (ICU) is high. This study determined the predictors of mortality in a cohort of critically ill patients with hematologic malignancies admitted to the ICU.
  
  
  METHODS
  We studied 227 critically ill patients with hematologic malignancies who were admitted to the ICU between April 2009 and December 2011. A cohort of consecutive patients with hematologic malignancies was reviewed retrospectively to identify clinically useful prognostic factors.
  
  
  RESULTS
  The ICU mortality rate was 84.1%, and the in-hospital mortality rate was 89.9%. The ICU mortality was significantly higher in patients with acute leukemia than in those with other malignancies. A significant difference between survivors and nonsurvivors was found in neutropenia and its recovery during the ICU stay, presence of cardiac dysfunction, the need for an invasive mechanical ventilator, use of inotropic/vasopressor agents, platelet count, aspartate transaminase level, pH, and Acute Physiology And Chronic Health Evaluation II score. In the multivariate analysis, acute leukemia, need for invasive mechanical ventilator, use of inotropic/vasopressor agents, and Acute Physiology And Chronic Health Evaluation II scores were independently associated with a worse outcome in patients with hematologic malignancies admitted to the ICU.
  
  
  CONCLUSIONS
  Higher mortality in patients with hematologic malignancies admitted to the ICU is associated with more severe illness, as reflected by higher organ failure scores or respiratory or hemodynamic instability. Mortality is higher in patients with acute leukemia as compared with other hematologic malignancies.
authors.affiliation: Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea.
authors.forename: Chang Dong
authors.initials: CD
authors.lastname: Yeo
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Seok Chan
authors.initials: SC
authors.lastname: Kim
authors.forename: Young Kyoon
authors.initials: YK
authors.lastname: Kim
authors.forename: Kwan Hyoung
authors.initials: KH
authors.lastname: Kim
authors.forename: Hee Je
authors.initials: HJ
authors.lastname: Kim
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
mesh_terms: D018806:APACHE; D015897:Comorbidity; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies