Outcome and Prognostic Factors in Patients with Hematologic Malignancies Admitted to the Intensive Care Unit: A Single-Center Experience

Ferrà, Christelle; Marcos, Pilar; Misis, Maite; Morgades, Mireia; Bordeje, Maria-Luisa; Oriol, Albert; Lloveras, Natàlia; Sancho, Juan‐Manuel; Xicoy, Blanca; Batlle, Montserrat; Klamburg, J.; Feliú, Evarist; Ribera, Josep‐Marǐa

doi:10.1532/ijh97.e0625

Cited by 61 publications

(57 citation statements)

References 29 publications

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“…Mean survival in the present study was lower than that previously reported, [29,30] and may have been due to several factors, including late presentation to hospital or a shortage of chemotherapeutic drugs. Improve outcome was reported for patients with early presentation and early stages of disease.…”

Section: (100) Totalcontrasting

confidence: 94%

The Pattern of Hematological Malignancies at Al-Gamhouria Teaching Hospital, Aden, Yemen, from 2008 to 2010

Hamid¹

2012

Turk J Hematol

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Objective: The aim of this study was to determine the pattern of hematological malignancies at Al-Gamhouria Teaching Hospital from 2008 to 2010.Material and Methods: Hematological malignancies diagnosed at Al-Gamhouria Teaching Hospital, Department of Hematology-Oncology from January 2008 to December 2010 based on available hematological laboratory methods and histological examination were retrospectively analyzed. Clinical diagnoses were based on history and physical examination. Complete blood count was performed in all patients, bone marrow aspiration was performed in leukemia and multiple myeloma patients, and histopathological examination was performed in cases of malignant lymphoma.Results: Malignant hematological disorders were diagnosed in 300 patients aged 18-80 years (mean age: 43.6 years) with a male:female ratio of 1.23:1. Among the male patients the most common malignant disorder was non-Hodgkin's lymphoma, followed by Hodgkin's lymphoma and acute myeloid leukemia. Among the female patients the most common malignant disorder was non-Hodgkin's lymphoma, followed by acute myeloid leukemia, and Hodgkin's lymphoma. The study provides the frequencies for the main hematological disorders and present the different subtypes of the Hodgkin's and non-Hodgkin's lymphomas. Conclusion:The most common hematological malignancies in male patients were Non-Hodgkin's lymphomas followed by Hodgkin's lymphoma and acute myeloid leukemia. Gender distribution showed male predominance with striking predominance in Hodgkin's lymphomas (M:F Ratio of 1.9:1).

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Section: (100) Totalcontrasting

confidence: 94%

The Pattern of Hematological Malignancies at Al-Gamhouria Teaching Hospital, Aden, Yemen, from 2008 to 2010

Hamid¹

2012

Turk J Hematol

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“…2,3,5,6 In that setting, mortality may reach 60 -90%. 7 Other factors associated with mortality were worse performance status on the Eastern Cooperative Oncology Group/World Health Organization scale, 8 allogeneic stem cell transplantation, high organ failure scores, increased organ dysfunction throughout the ICU stay, as well as diagnosis of invasive pulmonary aspergillosis. 2,4,9-13 ARF may be related to various etiologies, and failure to identify the cause is associated with increased mortality.…”

Section: Introductionmentioning

confidence: 99%

Identifying Cancer Subjects With Acute Respiratory Failure at High Risk for Intubation and Mechanical Ventilation

Lemiale¹,

Lambert

Canet

et al. 2014

Respir Care

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BACKGROUND: We sought to identify risk factors for mechanical ventilation in patients with malignancies and acute respiratory failure (ARF). METHODS:We analyzed data from a previous randomized controlled trial in which nonintubated oncology and hematology subjects with ARF were randomized to early bronchoalveolar lavage or routine care in 16 ICUs in France. Consecutive patients with malignancies were admitted to the ICU for ARF in 2005 and 2006 with no intervention. RESULTS: During the study period, 219 patients were admitted to the ICU for ARF, and 8 patients were not included due to a nonintubation order. Data on the underlying disease, pulmonary involvement, and extrapulmonary organ dysfunctions were recorded at admission in the 211 remaining subjects. Ventilatory support included oxygen only (49 subjects), noninvasive ventilation (NIV) only (81 subjects), NIV followed by invasive mechanical ventilation (49 subjects), and firstline invasive mechanical ventilation (32 subjects). The 81 subjects who required invasive mechanical ventilation were compared with the 130 subjects who remained on oxygen or NIV. Factors associated with invasive mechanical ventilation by multivariate analysis were the oxygen flow required at ICU admission, the number of quadrants involved on chest x-ray, and hemodynamic dysfunction. Mortality rates for subjects who had NIV failure were 65.3% compared with 50% for subjects who were first-line intubated (P ‫؍‬ .34). CONCLUSIONS: In cancer patients with ARF, hypoxemia, extent of pulmonary infiltration on chest x-ray, or hemodynamic dysfunction are risk factors for invasive mechanical ventilation. Mortality was not significantly different between NIV failure and first-line intubation.

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“…Survival rates may be increasing however since recent data demonstrate hospital and one year survival of 54-60% and 43%, respectively [9,10]. Outcomes after haemopoeitic stem cell transplantation (HSCT) appear to be worse [11], although there have been a number of papers suggesting that the prognosis may have improved even among HSCT recipients [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Outcomes for critically ill patients with haematological malignancies in specialist and non-specialist centres in the United Kingdom

Hampshire¹,

Pugh²,

Hajimichael³

2014

J Cancer Ther Res

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Background: Patients with haematological malignancies admitted to critical care units have a high mortality. Specialist cancer centres may demonstrate better survival rates than non-specialist centres. We compared the outcomes of patients with haematological malignancies admitted to three different centres in the United Kingdom, and examined possible reasons for differences in outcomes. Methods: We compared the characteristics and outcomes of patients with haematological malignancies admitted to critical care units at the Christie, Royal Liverpool University and Glan Clwyd hospitals between 1st January 2007 and 1st July 2011. Differences between hospitals were compared using ANOVA or Chi-squared test, as appropriate. Factors associated with hospital mortality were analysed using logistic regression analysis. Results: 187 patients with haematological malignancies were identified. More patients with Hodgkin's lymphoma were admitted to Glan Clwyd hospital (25%) compared to Royal Liverpool (5.8%) and the Christie (8.1%), p=0.0087. Patients admitted to the Christie had lower severity-of-illness scores compared to patients admitted to the other hospitals (p<0.001). Overall, 91 patients died before hospital discharge (48.7%). Unadjusted hospital mortality at the Christie was significantly lower (41.4%), compared to the Royal Liverpool (61.5%) and Glan Clwyd hospitals (54.2%), p=0.0240. On logistic regression analysis, the only factor associated with higher odds of hospital mortality was increasing APACHE II score (p=0.035, odds ratio 1.06 [95% CI 1.04-1.13] per point). Admission to a non-specialist centre was associated with higher odds of critical care unit mortality (p=0.036, odds ratio 2.17 [95% CI 1.05-4.46]), but was not associated with higher odds of hospital mortality (p=0.065). Conclusions: Admission to a specialist centre was not associated with lower hospital mortality compared to non-specialist centres for patients with haematological malignancies. However, admission to a specialist centre was associated with lower critical care unit mortality. Possible explanations for these differences in survival between centres could be the identified significant differences in casemix, or lower severity of illness at admission. In addition the severity of illness on admission to the critical care unit as indicated by the APACHE II score increased the odds of hospital mortality.

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Outcome and Prognostic Factors in Patients with Hematologic Malignancies Admitted to the Intensive Care Unit: A Single-Center Experience

Cited by 61 publications

References 29 publications

The Pattern of Hematological Malignancies at Al-Gamhouria Teaching Hospital, Aden, Yemen, from 2008 to 2010

The Pattern of Hematological Malignancies at Al-Gamhouria Teaching Hospital, Aden, Yemen, from 2008 to 2010

Identifying Cancer Subjects With Acute Respiratory Failure at High Risk for Intubation and Mechanical Ventilation

Outcomes for critically ill patients with haematological malignancies in specialist and non-specialist centres in the United Kingdom

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