Open AccessHemophagocytic Lymphohistiocytosis in Intensive Care Unit
Author(s) -
Thomas Barba,
Delphine Maucort-Boulch,
Jean Iwaz,
Julien Bohé,
J. Ninet,
A. Hot,
JeanChristophe Lega,
Claude Guérin,
Laurent Argaud,
C. Broussolle,
Yvan Jamilloux,
Jean-Christophe Richard,
P. Sève
Publication year - 2015
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000002318
Subject(s) - medicine , intensive care unit , retrospective cohort study , hemophagocytic lymphohistiocytosis , univariate analysis , intensive care , intensive care medicine , organ dysfunction , multivariate analysis , pediatrics , disease , emergency medicine , sepsis
Hemophagocytic lymphohistiocytosis (HLH) is a critical condition that may lead to organ failure and early death. The aim of this retrospective observational study was to describe a cohort of HLH patients admitted to intensive care unit (ICU) and investigate the risk factors of early death. A positive HLH diagnosis was defined by an HScore ≥169. Univariate and multivariate analyses were carried out to investigate hospital and 28-day mortality risk factors. Between January 2002 and July 2014, 71 HLH cases were seen at our institution. The overall 28-day mortality (start at ICU admission) and hospital mortality were 38% and 68%, respectively. The factors associated with increased 28-day mortality were the sequential organ failure assessment score at ICU admission ( P < .001) and advance in age ( P = 0.03). The factors associated with increased hospital mortality were a high sequential organ failure assessment score at ICU admission ( P < 0.01), advance in age ( P = 0.04), and the presence of lymphoma-related HLH or HLH of unknown origin ( P < 0.01). Organ failure overtops the classical early-death risk factors in adult ICU-admitted HLH patients. This failure and the subsequent early death may be prevented by timely specific cytotoxic therapies and the control of the underlying disease.