title: Predictors of Poor Outcomes in Critically Ill Adults with Hematologic Malignancy.
abstract: Background. Patients with hematologic malignancy (HM) often require intensive care unit (ICU) admission due to organ failure through disease progression or treatment-related complications. Objective. To determine mortality and prognostic variables in adult patients with HM who were admitted to ICU. Methods. Structured chart review of all adult patients (age ≥ 18 years) with HM admitted to ICU of a Canadian tertiary care hospital between 2004 and 2014. Outcome measures included mortality (ICU, 30-day, 60-day, and 12-month). Logistic regression was performed to determine predictors of mortality. Results. Overall, there were 206 cases of HM admitted to the ICU during the study (mean age: 51.3 ± 13.6 years; 60% male). Median stay was 3 days, with 14.1% requiring prolonged ICU admission. ICU mortality was 45.6% and increased to 59.2% at 30 days, 62.6% at 60 days, and 74.3% at 12 months. Predictors of increased ICU mortality included mechanical ventilation requirement and vasopressor therapy requirement, while admission to ICU postoperatively and having myeloma were associated with decreased mortality. Conclusions. Patients admitted to ICU with HM have high mortality (45.6%), which increased to 74.3% at 1 year. Analysis of multiple variables identified critical illness, postsurgical admission, and myeloma as predictors of patient outcomes.
authors.affiliation: Department of Critical Care, Dalhousie University, Halifax, NS, Canada B3H 2Y9.
authors.forename: Marion
authors.initials: M
authors.lastname: Cornish
authors.affiliation: Department of Critical Care, Dalhousie University, Halifax, NS, Canada B3H 2Y9.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Butler
authors.affiliation: Department of Critical Care, Dalhousie University, Halifax, NS, Canada B3H 2Y9; Trauma Nova Scotia, Halifax, NS, Canada B3H 2Y9.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000740:Anemia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D016638:Critical Illness / Q000401:mortality*; D064147:Febrile Neutropenia / Q000453:epidemiology; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D007938:Leukemia / Q000401:mortality; D016015:Logistic Models; D008223:Lymphoma / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality; D009503:Neutropenia / Q000453:epidemiology; D009674:Nova Scotia / Q000453:epidemiology; D011379:Prognosis; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000453:epidemiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents