AML-005 Analysis of 206 Oncohematological Patients Admitted to the Intensive Care Unit

Abstract

The intensive care unit (ICU) provides support to oncohematology (OH) patients. There is a trend to delay admission of OH patients to the ICU. Currently, advances in the diagnosis and treatment, specific mutations, stem cell transplant, and immunotherapy have produced a change in the prognosis. A descriptive, retrospective cohort study was carried out on the population of adult OH patients who were admitted to the ICU, in the period from January 2009 to February 2021. The main outcome was to evaluate mortality in the ICU. The secondary outcome was associated with demographic and clinical variables (age, sex, underlying (OH) disease, transplant, shock, sepsis, mechanical ventilation (MV), hemodialysis, sensory impairment, neutropenia, bacteremia, APACHE II score, with mortality in the ICU. In this study, 206 OH patients were included. The median age was 59 years (IQR: 46-68), with a male predominance of 113 patients (54%). The median of hospitalization days was 15 (IQR: 8-28) whilst the median of ICU days was 5 (3-8). Mortality was evaluated at the time of discharge from the ICU, reaching 45% (93 patients), 47% at 30 days and 49% at 60 days. The median survival of the global population was 15.5 days (IQR: 4.25-60). The median APACHE II scored 22 points (IQR: 15-25). A statistically significant relationship was found in the multivariate analysis for mortality with the APACHE II variables (p = 0.0001) and the requirement for MV (p = 0.021). Using the ROC curve method, the APACHE II score value of 22 was obtained as the point of greatest statistical significance. The log-rank test method was used to compare patients with a value greater or less than 22. The median survival in days was (IQR): NR 5.5. vs HR 8.423, 95% CI 5.414 - 13.1, (p<0.0001). In conclusion, the value of 22 points scored on APACHE II and the requirement for MV was useful to discriminate survival expectancy between both groups of patients. This study provides information on OH patients at UCI in developing countries during the last 12 years.