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

Abstract：

OBJECTIVE:To assess the outcome of intensive care unit (ICU) treatment in patients with hematological malignancies. DESIGN AND SETTING:Retrospective cohort study in the medical ICU of a university hospital. PATIENTS:104 critically ill patients after receiving conventional chemotherapy or autologous hematopoietic stem cell transplantation. INTERVENTIONS:We analyzed demographic data, underlying disease, intensity of antineoplastic regimen, cause of admission, need for mechanical ventilation, and hemofiltration, ICU survival, and survival after discharge, furthermore neutrophil count, C-reactive protein (150 mg/l), antithrombin III, prothrombin time, and SAPS II (50) at ICU admission. All recorded variables were evaluated for prognostic relevance by univariate and multivariate analyses. MEASUREMENTS AND RESULTS:Overall ICU mortality was 44%, with significantly higher mortality in ventilated patients (74% vs. 12% in nonventilated patients, p<0.001). Overall survival for the entire group 6 months and 1 year after ICU admission was 33% and 29%, respectively. Multivariate analysis revealed mechanical ventilation and SAPS II as independent prognostic factors of both ICU mortality and long-term survival, while C-reactive protein predicted only ICU mortality. CONCLUSIONS:The outcome of patients not requiring ventilatory support in this study was encouraging, while invasive ventilation was again confirmed as predicting a dismal prognosis in this population. Efforts should be directed to avoiding this procedure by reducing the pulmonary toxicity of antineoplastic treatment and to making ventilatory support more tolerable.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Kroschinsky F,Weise M,Illmer T,Haenel M,Bornhaeuser M,Hoeffken G,Ehninger G,Schuler U

doi

10.1007/s00134-002-1420-5

keywords:

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

1294-300

issue

9

eissn

0342-4642

issn

1432-1238

journal_volume

28

pub_type

杂志文章

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