Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;53(1):340-351.
doi: 10.55730/1300-0144.5590. Epub 2023 Feb 22.

Risk factors for ICU mortality in patients with hematological malignancies: a singlecenter, retrospective cohort study from Turkey

Şahender Gülbin Aygencel Bıkmaz  1 , Onur Gökçe  1 , Meryem Merve Haşimoğlu  1 , Nazlıhan Boyacı  1 , Melda Türkoğlu  1 , Zeynep Arzu Yeğin  2 , Zübeyde Nur Özkurt  2 , Abdullah Münci Yağcı  2
Affiliations

Risk factors for ICU mortality in patients with hematological malignancies: a singlecenter, retrospective cohort study from Turkey

Şahender Gülbin Aygencel Bıkmaz et al. Turk J Med Sci. 2023 Feb.

Abstract

Background: Patients with hematological malignancies (HM) often require admission to the intensive care unit (ICU) due to organ failure, disease progression or treatment-related complications, and they generally have a poor prognosis. Therefore, understanding the factors affecting ICU mortality in HM patients is important. In this study, we aimed to identify the risk factors for ICU mortality in our critically ill HM patients.

Methods: We retrospectively reviewed the medical records of HM patients who were hospitalized in our medical ICU between January 1, 2010 and December 31, 2018. We recorded some parameters of these patients and compared these parameters by statistically between survivors and nonsurvivors to determine the risk factors for ICU mortality.

Results: The study included 368 critically ill HM patients who were admitted to our medical ICU during a 9-year period. The median age was 58 (49-67) years and 63.3% of the patients were male. Most of the patients (43.2%) had acute leukemia. Hematopoietic stem cell transplantation (HSCT) was performed in 153 (41.6%) patients. The ICU mortality rate was 51.4%. According to univariable analyses, a lot of parameters (e.g., admission APACHE II and SOFA scores, length of ICU stay, some laboratory parameters at the ICU admission, the reason for ICU admission, comorbidities, type of HM, type of HSCT, infections on ICU admission and during ICU stay, etc.) were significantly different between survivors and nonsurvivors. However, only high SOFA scores at ICU admission (OR:1.281, p = 0.004), presence of septic shock (OR:17.123, p = 0.0001), acute kidney injury (OR:48.284, p = 0.0001), and requirement of invasive mechanical ventilation support during ICU stay (OR:23.118, p = 0.0001) were independent risk factors for ICU mortality.

Discussion: In our cohort, critically ill HM patients had high ICU mortality. We found four independent predictors for ICU mortality. Yet, there is still a need for further research to better understand poor outcome predictors in critically ill HM patients.

Keywords: Outcome; SOFA score; acute renal failure; hematological malignancy patients; intensive care unit; invasive mechanical ventilation; prognostic factors; septic shock.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

All authors have read and approved the final version of the manuscript. The authors state that there is no conflict of interest related to this study.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
ROC curve for SOFA score at ICU admission (AUC: 0.731, 95% CI 0.680–0.782, p = 0.0001).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Cuthbertson BH, Rajalingam Y, Harrison S, McKirdy F. The outcome of haematological malignancy in Scottish intensive care units. Journal of the Intensive Care Society (JICS) 2008;9(2):135–140. doi: 10.1177/175114370800900208. - DOI
    1. Bird GT, Farquhar-Smith P, Wigmore T, Potter M, Gruber PC. Outcomes and prognostic factors in patients with haematological malignancy admitted to a specialist cancer intensive care unit: a 5 yr study. British Journal of Anaesthesia. 2012;108:452–459. doi: 10.1093/bja/aer449. - DOI - PubMed
    1. Yeo CD, Kim JW, Kim SC, Kim YK, Kim KH, et al. Prognostic factors in critically ill patients with hematologic malignancies admitted to the intensive care unit. Journal of Critical Care. 2012;27(739):e1–6. doi: 10.1016/j.jcrc.2012.07.014. - DOI - PubMed
    1. Hampshire PA, Welch CA, McCrossan LA, Francis K, Harrison DA. Admission factors associated with hospital mortality in patients with haematological malignancy admitted to UK adult, general critical care units: a secondary analysis of the ICNARC Case Mix Programme Database. Critical Care. 2009;13(4):R137. doi: 10.1186/cc8016. - DOI - PMC - PubMed
    1. Azoulay E, Recher C, Alberti C, Soufir L, Leleu G, et al. Changing use of intensive care for hematological patients: the example of multiple myeloma. Intensive Care Med. 1999;25(12):1395–1401. doi: 10.1007/s001340051087. - DOI - PubMed
-