1. Long-Term Outcome of Patients With a Hematologic Malignancy and Multiple Organ Failure Admitted at the Intensive Care
- Author
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Vries, V.A. de, Muller, M.C.A., Arbous, M.S., Biemond, B.J., Blijlevens, N.M.A., Kusadasi, N., Span, L.R.F., Vlaar, A.P.J., Westerloo, D.J. van, Kluin-Nelemans, H.C., Bergh, W.M. van den, Tuinman, P.R., Spoelstra, A., Marijt, E., Blijlevens, N., Hilkens, M., Epker, J., Broers, A., Choi, G., Demandt, A., Mook, W. van, HEMA-ICU Study Grp, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care Medicine, Clinical Haematology, CCA - Cancer Treatment and Quality of Life, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Emergency Medicine, Interne Geneeskunde, MUMC+: MA Hematologie (9), RS: SHE - R1 - Research (OvO), Intensive Care, MUMC+: MA Medische Staf IC (9), Intensive care medicine, and ACS - Diabetes & metabolism
- Subjects
Male ,IMPACT ,Kaplan-Meier Estimate ,Critical Care and Intensive Care Medicine ,intensive care unit ,law.invention ,multiple organ failure/mortality ,0302 clinical medicine ,PROGNOSTIC-FACTORS ,law ,Medicine ,Netherlands ,Mortality rate ,Acute kidney injury ,GROUPE ,Online Clinical Investigations ,CHEMOTHERAPY ,Middle Aged ,Intensive care unit ,ADMISSION ,Intensive Care Units ,Treatment Outcome ,Hematologic Neoplasms ,SURVIVAL ,Female ,CRITICALLY-ILL PATIENTS ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] ,medicine.medical_specialty ,Multiple Organ Failure ,CANCER-PATIENTS ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Intensive care ,Internal medicine ,Humans ,organ failure ,Survival rate ,Survival analysis ,Retrospective Studies ,business.industry ,030208 emergency & critical care medicine ,Retrospective cohort study ,medicine.disease ,Survival Analysis ,SEVERITY ,030228 respiratory system ,Respiratory failure ,UNIT ,hematologic malignancy ,prognosis ,business - Abstract
Objectives: Historically, patients with a hematologic malignancy have one of the highest mortality rates among cancer patients admitted to the ICU. Therefore, physicians are often reluctant to admit these patients to the ICU. The aim of our study was to examine the survival of patients who have a hematologic malignancy and multiple organ failure admitted to the ICU. Design: This retrospective cohort study, part of the HEMA-ICU study group, was designed to study the survival of patients with a hematologic malignancy and organ failure after admission to the ICU. Patients were followed for at least 1 year. Setting: Five university hospitals in the Netherlands. Patients: One-thousand ninety-seven patients with a hematologic malignancy who were admitted at the ICU. Interventions: None. Measurements and Main Results: Primary outcome was 1-year survival. Organ failure was categorized as acute kidney injury, respiratory failure, hepatic failure, and hemodynamic failure; multiple organ failure was defined as failure of two or more organs. The World Health Organization performance score measured 3 months after discharge from the ICU was used as a measure of functional outcome. The 1-year survival rate among these patients was 38%. Multiple organ failure was inversely associated with long-term survival, and an absence of respiratory failure was the strongest predictor of 1-year survival. The survival rate among patients with 2, 3, and 4 failing organs was 27%, 22%, and 8%, respectively. Among all surviving patients for which World Health Organization scores were available, 39% had a World Health Organization performance score of 0-1 3 months after ICU discharge. Functional outcome was not associated with the number of failing organs. Conclusions: Our results suggest that multiple organ failure should not be used as a criterion for excluding a patient with a hematologic malignancy from admission to the ICU.
- Published
- 2019
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