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Short- and long-term outcomes of AL amyloidosis patients admitted into intensive care units
- Source :
- British Journal of Haematology. 174:868-875
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Amyloidosis is a rare and threatening condition that may require intensive care because of amyloid deposit-related organ dysfunction or therapy-related adverse events. Although new multiple myeloma drugs have dramatically improved outcomes in AL amyloidosis, the outcomes of AL patients admitted into intensive care units (ICUs) remain largely unknown. Admission has been often restricted to patients with low Mayo Clinic staging and/or with a complete or very good immunological response at admission. In a retrospective multicentre cohort of 66 adult AL (n = 52) or AA (n = 14) amyloidosis patients, with similar causes of admission to an ICU, the 28-d and 6-month survival rates of AA patients were significantly higher compared to AL patients (93% vs. 60%, P = 0·03; 71% vs. 45%, P = 0·02, respectively). In AL patients, the simplified Index of Gravity Score (IGS2) was the only independent predictive factor for death by day 28, whereas the Mayo-Clinic classification stage had no influence. In Cox's multivariate regression model, only cardiac arrest and on-going chemotherapy at ICU admission significantly predicted death at 6 months. Short-term outcomes of AL patients admitted into an ICU were mainly related to the severity of the acute medical condition, whereas on-going chemotherapy for active amyloidosis impacted on long-term outcomes.
- Subjects :
- Adult
Male
medicine.medical_specialty
Critical Care
030204 cardiovascular system & hematology
Risk Assessment
Severity of Illness Index
law.invention
03 medical and health sciences
Patient Admission
0302 clinical medicine
law
Intensive care
Internal medicine
Severity of illness
AL amyloidosis
Humans
Medicine
Hospital Mortality
Survival analysis
Aged
business.industry
Amyloidosis
Organ dysfunction
Disease Management
Hematology
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Intensive care unit
Surgery
Patient Outcome Assessment
Intensive Care Units
Cohort
Female
Immunoglobulin Light Chains
medicine.symptom
business
030215 immunology
Subjects
Details
- ISSN :
- 00071048
- Volume :
- 174
- Database :
- OpenAIRE
- Journal :
- British Journal of Haematology
- Accession number :
- edsair.doi.dedup.....e83dfa6bf621904890e75204e1ace00a