Introduction
Acute illness in patients with underlying haematological disease is associated with poor prognosis. Recent reports suggest improved outcomes in these patients except for those with bone marrow transplantation (BMT) or recent chemotherapy [1]. We sought to audit the overall outcome and potential determinants of outcome in these patients admitted to our ICU.
Methods
Retrospective data on demographics, underlying haematological diagnosis, BMT, recent chemotherapy, reason for acute illness, severity of acute physiological derangement (severe acute physiological score (SAPS), number of failed organs, need for invasive mechanical ventilation and renal support), and ICU and hospital outcomes were collected for 106 consecutive admissions (97 patients) between January 2005 and December 2008. Re-admissions were excluded (9/106 patients). Data were analysed with SPSS software.
Results
Of the 97 patients, NHL (30.9%) and AML (26.8%) accounted for most haematological diagnoses. A total 24.7% were post-BMT, and 36.1% had chemotherapy within a month of admission or on the ICU. The mean (SD) age was 49 (15), SAPS 55 (16) and 56.7% were males. The mortality at ICU and hospital discharge was 51.5% and 63.9%, respectively. Gender, neutropaenia (≤1 × 109/l), haematological diagnosis, admission reason, HIV status, BMT and recent chemotherapy were not predictive of ICU or hospital outcome (P > 0.05). SAPS, invasive mechanical ventilation (IMV), renal support (RS) and sequential number of organs supported (OS) were predictive of both ICU and hospital mortality outcomes (P < 0.05).
Conclusions
There is ongoing heightened risk of mortality in patients with haematology diagnoses admitted to the ICU with acute illness, related to both the severity of the initial physiological disturbance and requirements for organ support. In our patient population, BMT and recent chemotherapy were not associated with increased mortality, but this will need further evaluation with a larger sample size.
References
Cuthbertson BH, Rajalingam Y, Harrison S, McKirdy F: The outcome of haematological malignancy in Scottish intensive care units. J Intensive Care Soc 2008, 9: 135-140.
Author information
Authors and Affiliations
Additional information
An erratum to this article is available at http://dx.doi.org/10.1186/cc11424.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
José, R., McDonald, I., Pfeffer, P. et al. Outcome of haematology patients admitted to intensive care in a tertiary centre: primary haematological diagnosis, recent chemotherapy and bone marrow transplantation are not associated with outcome. Crit Care 15 (Suppl 1), P497 (2011). https://doi.org/10.1186/cc9917
Published:
DOI: https://doi.org/10.1186/cc9917