Long-held assumptions of poor prognoses for patients with HM have meant that clinicians have been reluctant to admit them to the intensive care unit (ICU). However, over the past few years several centers across the world have shown that it is possible to achieve a meaningful survival in these patients. Methods: The aim of this study was to assess the characteristics and outcomes of patient with haematological malignancy admitted to the intensive care unit (ICU). We performed a retrospective cohort study among adult HM patients admitted to the ICU in Moewardi Hospital between January 2015 and December 2016. Medical history, physical and laboratory findings on admission, and therapeutic interventions during ICU stay were recorded. The study endpoint was ICU mortality. Results: Nineteen patients were admitted to ICU, the median age was 52 years (21-73), and 67% were female. The mean ICU length of stay was 3 days (SD 2.8). The main acute life-threatening diseases precipitating ICU transfer were septic shock (8 patients, 44%) and respiratory failure (5 patients, 28%). Acute Myeloid Leukemia (AML) was the main diagnosis in this study (39%). Most of these patients had anemia (72%) with the median of hemoglobin was 8.8 (3.9-12). Twenty eight percent of patients needed invasive mechanical ventilation and 60% of these died. ICU mortality was 50%. Conclusions: Patients admitted to ICU with HM have high mortality. Early recognition of critical illness is required to enable prompt referral of patients who may benefit from critical care. Multicenter outcome studies on patients with HM who require ICU admission are needed.
Background: Cancer and its therapy produce various symptoms that may have an impact on the patients' lives and cause significant burdens. Late presentations to medical care and delays in treatments are factors that may lead from a cancer progression to a more advanced stage and hence a poorer prognosis. It is important for healthcare providers to understand the patients' symptom burdens in order to improve the physical and psychological well-being of the patients. The aim of this study is to identify the association between patient delay (PD) and treatment delay (TD) with symptom burdens in Indonesia cancer patients. Methods: This is a cross sectional study that took place in Siloam General Hospital, Tangerang, a suburban area in Indonesia from July 2016 to January 2017. The samples included in this study were solid cancer patients. Symptom burden was assessed using Memorial Symptom Assessment Scale-Short Form (MSAS-SF) questionnaire. Patients were classified as PD if the time from first symptom to medical presentation is more than 3 months and classified as TD if the time from first diagnosis by a medical professional to medical treatment is more than 1 month. Analysis was done using Students' T-test or Mann-Whitney. Results: A total of 56 patients were included in our study, out of which 50 (89.3%) were female. The mean age of the patients was 48.6 610.9 years. Breast cancer was the most common type of cancer (76.7%), followed by adenocarcinoma of the colon (8.9%). PD and TD were present in 24 (42.9%) and 21 (37.5%) patients respectively. PD had significant association with global distress index subscale (p ¼ 0.017) and total score of symptom burden (p ¼ 0.026). TD had significant association with global distress index (p: 0.024) subscale, physical symptom subscale (p: 0.024) and total score of symptom burden (p ¼ 0.022). Conclusions: Patient delay and treatment delay were associated with higher levels of symptom burden in Indonesian cancer patients.
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