title: Characteristics and outcomes of haematology patients admitted to the intensive care unit.
abstract: OBJECTIVE
  To profile the characteristics and outcomes of adult haematology patients admitted to the intensive care unit (ICU).
  
  
  BACKGROUND
  The role of intensive care support for haematology patients is contentious due to high mortality rates thus generating debate regarding the inappropriate use of limited resources versus denial of effective care.
  
  
  METHODS
  Medical notes, laboratory records and Intensive Care National Audit and Research Centre (ICNARC) data for all adult haematology patients admitted to Belfast City Hospital ICU in 2009 were analysed.
  
  
  RESULTS
  Twenty one patients were admitted to the ICU; mean age was 56 years (SD 12·5), 52% were male and 82% (n=19) had a malignant diagnosis. The main indication for admission was neutropenic sepsis with associated organ impairment (n=18, 85%). ICU mortality was 43%. Three-month and six-month mortality rates were 62% and 67%, respectively. ICU survivors had lower acute physiology and chronic health evaluation (APACHE II) scores, and decreased requirements for invasive ventilation and inotropic support. Of the post-six-month survivors, one had a relapse, one had responding disease and five remained in remission. Two patients have subsequently undergone a reduced intensity conditioning transplant.
  
  
  CONCLUSIONS
  One third of patients survived for >6 months indicating that critically ill haematology patients can benefit from ICU admission, allowing progression to potentially curative therapies.
  
  
  CONCLUSIONS
  This study highlights the necessity of individualized assessment regarding patient suitability for admission to a critical care facility, incorporating the perspective of both the haematologist and the intensivist.
authors.affiliation: Belfast Health and Social Care Trust and School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK. caroline.mccaughey@qub.ac.uk
authors.forename: Caroline
authors.initials: C
authors.lastname: McCaughey
authors.forename: Bronagh
authors.initials: B
authors.lastname: Blackwood
authors.forename: Marie
authors.initials: M
authors.lastname: Glackin
authors.forename: Michele
authors.initials: M
authors.lastname: Brady
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: McMullin
mesh_terms: D018806:APACHE; D000328:Adult; D002423:Cause of Death; D003131:Combined Modality Therapy; D003422:Critical Care / Q000458:organization & administration; D064648:Critical Care Nursing / Q000379:methods; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome