Premium
Sequential organ failure predicts mortality of patients with a haematological malignancy needing intensive care
Author(s) -
Cornet Alexander D.,
Issa Aart I.,
Loosdrecht Arjan A.,
Ossenkoppele Gert J.,
Van Schijndel Rob J. M.,
Johan Groeneveld A. B.
Publication year - 2005
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2005.00418.x
Subject(s) - medicine , intensive care unit , sofa score , intensive care , sepsis , saps ii , malignancy , anesthesiology , mortality rate , intensive care medicine , septic shock , retrospective cohort study , emergency medicine , apache ii , anesthesia
Objectives : Poor survival of patients with a haematological malignancy admitted to the intensive care unit (ICU) prompts for proper admission triage and prediction of ICU treatment failure and long‐term mortality. We therefore tried to find predictors of the latter outcomes. Methods : A retrospective analysis of charts and a prospective follow‐up study were done, of haemato‐oncological patients, admitted to our ICU in a 7‐year period with a follow‐up until 2 yr thereafter. Clinical parameters during the first four consecutive days were taken to calculate the simplified acute physiology (SAPS II) and the sequential organ failure assessment (SOFA) scores, of proven predictive value in general ICU populations. Results : From a total of 58 patients ( n = 47 with acute myelogenous leukaemia or non‐Hodgkin lymphoma), admitted into ICU mostly because of respiratory insufficiency, sepsis, shock or combinations, 36 patients had died during their stay in the ICU. Of ICU survivors ( n = 22), 20 patients died during follow‐up so that the 1‐year survival rate was only 12%. The SAPS II and particularly the SOFA scores were of high predictive value for ICU and long‐term mortality. Conclusions : Patients with life‐threatening complications of haematological malignancy admitted to ICU ran a high risk for death in the ICU and on the long‐term, and the risk can be well predicted by SOFA. The latter may help us to decide on intensive care in individual cases, in order to avoid potentially futile care for patients with a SOFA score of 15 or higher.