Prognostic factors in critically ill patients with hematological malignancy admitted to the general intensive care unit: a single-center experience in Japan.

Abstract

This study aims to identify prognostic factors related to short-term and long-term outcomes of patients with hematological malignancy (HM) admitted to the intensive care unit (ICU) in Japan during ICU stay and after discharge from ICU. We conducted a retrospective, observational study of 169 patients with HM admitted to the general ICU from January 2009 to December 2016. We examined prognostic factors affecting outcome during ICU stay and at 180days after ICU discharge using logistic regression analysis. During ICU stay, 57 patients (33.7%) died. Invasive mechanical ventilation (OR 8.96, 95% CI 3.67-21.9; P<0.001, the same hereinafter), the Sequential Organ Failure Assessment (SOFA) score within the first 24h of ICU admission (1.25, 1.11-1.40; P<0.001), and malignant lymphoma (0.30, 0.11-0.78; P=0.014) were detected as factors associated with ICU outcome. Of 112 ICU survivors, 46 (41.1%) died within 180days after ICU discharge. Duration of ICU stay (1.07, 1.01-1.13; P=0.027) and the SOFA score at ICU discharge (1.24, 1.04-1.48; P=0.016) were related to poor outcome at 180days after ICU discharge. In critically ill patients with HM, the use of invasive mechanical ventilation, a high SOFA score within the first 24h of ICU admission, and malignant lymphoma as primary HM affected short-term ICU outcome. Increased duration of ICU stay and SOFA score at ICU discharge influenced long-term outcome at 180days after ICU discharge.