Clinical characteristics and outcomes of bone marrow transplantation patients presenting to the ED of a tertiary care center.

Abstract

Bone marrow transplantation is a breakthrough in the world of hematology and oncology. In our region, there is scarce literature studying emergency department visits among BMT patients, as well as their predictors of mortality. This study aimed to assess the frequency, reasons, clinical characteristics and outcomes of patients presenting to the ED after a BMT, and to study the predictors of mortality in those patients. This study also compares those variables among the different types of BMT. This was a retrospective cohort study conducted on all adult patients who have completed a successful BMT and visited the ED. Our study included 115 BMT patients, of whom 17.4% died. Those who died had a higher median number of ED visits than those who did not die. Around 36.5% presented with fever/chills with 29.6% diagnosed with pneumonia on discharge. We found that the odds of mortality were significantly higher among those who presented with dyspnea (p<.0005) and AMS (p=.023), among septic patients (p=.001), those who have undergone allogeneic BMT (p=.037), and those who were admitted to the ICU (p=.002). Moreover, the odds of mortality were significantly higher among hypotensive (p≤0005) and tachycardic patients (p=.015). In our study, we have shown that BMT patients visit the ED very frequently and have high risk of in-hospital mortality. Moreover, our study showed a significant association between mortality and patients with dyspnea, AMS, sepsis, allogeneic BMT type, ICU admission, hypotension and tachycardia.