title: Survival of hematological patients after discharge from the intensive care unit: a prospective observational study.
abstract: BACKGROUND
  Although the survival rates of hematological patients admitted to the ICU are improving, little is known about the long-term outcome. Our objective was to identify factors related to long-term outcome in hematological patients after ICU discharge.
  
  
  METHODS
  A prospective, observational study was carried out in seven centers in Spain. From an initial sample of 161 hematological patients admitted to one of the participating ICUs during the study period, 62 were discharged alive and followed for a median time of 23 (1 to 54) months. Univariate and multivariate analysis were performed to identify the factors related to long term-survival. Finally, variables that influence the continuation of the scheduled therapy for the hematological disease were studied.
  
  
  RESULTS
  Mortality after ICU discharge was 61%, with a median survival of 18 (1 to 54) months. In the multivariate analysis, an Eastern Cooperative Oncology Group score (ECOG) >2 at ICU discharge (Hazard ratio 11.15 (4.626 to 26.872)), relapse of the hematological disease (Hazard ratio 9.738 (3.804 to 24.93)) and discontinuation of the planned treatment for the hematological disease (Hazard ratio 4.349 (1.286 to 14.705)) were independently related to mortality. Absence of stem cell transplantation, high ECOG and high Acute Physiology and Chronic Health Evaluation II (APACHE II) scores decreased the probability of receiving the planned therapy for the hematological malignancy.
  
  
  CONCLUSIONS
  Both ICU care and post-ICU management determine the long-term outcome of hematological patients who are discharged alive from the ICU.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bernal
authors.forename: Estefanía V
authors.initials: EV
authors.lastname: Pardavila
authors.forename: Juan
authors.initials: J
authors.lastname: Bonastre
authors.forename: Isidro
authors.initials: I
authors.lastname: Jarque
authors.forename: Marcio
authors.initials: M
authors.lastname: Borges
authors.forename: Joan
authors.initials: J
authors.lastname: Bargay
authors.forename: Jose Ignacio
authors.initials: JI
authors.lastname: Ayestarán
authors.forename: Josu
authors.initials: J
authors.lastname: Insausti
authors.forename: Pilar
authors.initials: P
authors.lastname: Marcos
authors.forename: Victor
authors.initials: V
authors.lastname: González-Sanz
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Camblor
authors.forename: Guillermo M
authors.initials: GM
authors.lastname: Albaiceta
mesh_terms: D018806:APACHE; D003663:Decision Trees; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009503:Neutropenia / Q000150:complications; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012121:Respiration, Artificial; D012307:Risk Factors; D015996:Survival Rate