Hematolojik kanser tanısıyla yoğun bakım ünitesinde takip edilen hastaların klinik özelliklerinin ve sonuçlarının değerlendirilmesi: tek merkez deneyimi

Abstract

Introduction: Patients diagnosed with hematological cancer (HC) often need intensive care during their follow-up and treatment. In this study, it was aimed to evaluate the clinical characteristics and follow-up results of patients diagnosed with HC who were followed up in the intensive care unit (ICU). Materials and methods: This is a retrospective study enrolling 77 adult HC patients requiring intensive care between February 2019 and March, 2020. Results: Thirty-eight (50.6%) patients included in the study were neutropenic and 67 patients (87%) had infection during admission to the ICU. Acute myeloid leukemia was diagnosed in 35 (45.5%) patients. Mechanical ventilation was applied to 56 (72.7%) patients on admission. In the follow-up, 32 (41.6%) patients developed ICU infection, 24 (31.2%) patients developed bacteremia. The most common pathogens were; Klebsiella pneumonia (n = 11, 14.3%) and non-fermentation bacteria (n = 13, 16.6%) were gram-negative bacilli. Overall ICU survival rate was 32.5% (n: 25). Variables predicted to affect mortality in univariate analysis; APACHE II score ≥ 25 (p <0.001), resistance to cancer treatment or relapse (p = 0.015), septic shock at hospitalization (p <0.001), need for invasive mechanical ventilation (p <0.001) and presence of hospital infection (p = 0.006) were statistically were found to be significant risk factors. As a result of the multivariate model established with these variables, it was seen that the APACHE II score was a significant predictor for mortality (ROC: 0.884). Conclusion: APACHE II score 25 and septic shock are important poor prognosis criteria. Successful treatment and long survival can be achieved by the protocols to be determined in the follow-up and treatment of HC patients in need of intensive care, supportive treatments and prevention of nosocomial infections.