Long term prognosis and quality of life following intensive care for life-threatening complications of haematological malignancy

Abstract

Summary Ninety-two consecutive adult patients admitted with acute life-threatening complications of haematological malignancy were studied to determine long term outcome. The quality of life was evaluated in seven long term survivors who are currently alive more than I year after hospital discharge using three validated methods: the Nottingham Health Profile, the Hospital Anxiety and Depression Scale and the Perceived Quality of Life Scale. Patients were also asked whether they had returned to work, whether their daily activities were limited and whether they would be willing to undergo intensive care again under the same circumstances. The in-hospital mortality rate was 77%. Median duration of long term survival was 23 months (range 6 weeks to 8 years). Long term survival did not appear to be related to either the aetiology or the severity of the acute illness, but seemed to be determined solely by the nature and progress of the underlying malignancy. The quality of life of six of the seven long term survivors is good, while that of the other is acceptable. None of the patients reported any increased limitation of their daily activities, five had returned to full time employment and all seven stated that they would be willing to undergo intensive care again under the same circumstances.

Admission of bone marrow transplant recipients to the intensive care unit: outcome, survival and prognostic factors

“…While some authors have suggested that patients surviving ICU have a poor long-term prognosis with most dying of complications or recurrent disease, our experience suggests that 60% of hospital discharge survivors can be expected to be alive and well with a good performance status at a median of 4.2 years following ICU discharge. This finding is similar to that observed by Yau et al 19 who found that quality of life in long-term survivors of patients admitted to ICU during treatment of haematological malignancy was good with all patients saying they would wish to receive ICU support again under similar circumstances. The issue of length of ICU stay is also clouded by intangible factors.…”

Outcome and prognostic features of intensive care unit treatment in patients with hematological malignancies

“…Studies during the 1980s on the outcome of hemoblastosis patients receiving intensive care for life-threatening complications found short-term mortality rates between 70% and 78% [19,20,21]. In contrast to this, the overall ICU mortality of 44% in this series is comparable to what has been reported in more recently published experiences [2,4,5] and confirms the observation that the prognosis of critically ill cancer patients has been improved over time.…”

Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and a satisfaction scale

“…These differences could be related, in part, to differences in populations studied. Among all the published data on quality of life after an ICU stay, only one study has used the association of NHP and PQOL, evaluating patients with haematological malignancies [23]. Although the number of survivors was low (7 patients 1 year after discharge among 92 patients included), scores in both scales showed moderate impairment in health status as well as a high degree of satisfaction.…”