Survival of hematological patients after discharge from the intensive care unit: a prospective observational studyReport as inadecuate




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Critical Care

, 17:R302

First Online: 30 December 2013Received: 19 August 2013Accepted: 27 November 2013

Abstract

IntroductionAlthough the survival rates of hematological patients admitted to the ICU are improving, little is known about the long-term outcome. Our objective was to identify factors related to long-term outcome in hematological patients after ICU discharge.

MethodsA prospective, observational study was carried out in seven centers in Spain. From an initial sample of 161 hematological patients admitted to one of the participating ICUs during the study period, 62 were discharged alive and followed for a median time of 23 1 to 54 months. Univariate and multivariate analysis were performed to identify the factors related to long term-survival. Finally, variables that influence the continuation of the scheduled therapy for the hematological disease were studied.

ResultsMortality after ICU discharge was 61%, with a median survival of 18 1 to 54 months. In the multivariate analysis, an Eastern Cooperative Oncology Group score ECOG >2 at ICU discharge Hazard ratio 11.15 4.626 to 26.872, relapse of the hematological disease Hazard ratio 9.738 3.804 to 24.93 and discontinuation of the planned treatment for the hematological disease Hazard ratio 4.349 1.286 to 14.705 were independently related to mortality. Absence of stem cell transplantation, high ECOG and high Acute Physiology and Chronic Health Evaluation II APACHE II scores decreased the probability of receiving the planned therapy for the hematological malignancy.

ConclusionsBoth ICU care and post-ICU management determine the long-term outcome of hematological patients who are discharged alive from the ICU.

AbbreviationsANOVAAnalysis of variance

APACHEAcute physiology and chronic health evaluation

AUCArea under the curve

CLLChronic lymphoid leukemia

cMPNChronic myeloproliferative neoplasm

COPDChronic obstructive pulmonary disease

ECOG scoreEastern Cooperative Oncology Group score

HRHazard ratio

MDSMyelodysplastic syndrome

MVMechanical ventilation

NIMVNon-invasive mechanical ventilation

ROCReceiver operating characteristic.

Electronic supplementary materialThe online version of this article doi:10.1186-cc13172 contains supplementary material, which is available to authorized users.

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Author: Teresa Bernal - Estefanía V Pardavila - Juan Bonastre - Isidro Jarque - Marcio Borges - Joan Bargay - Jose Ignacio Ayest

Source: https://link.springer.com/







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