Characteristics and outcomes of patients with a haematological malignancy admitted to the intensive care unit for a neurological event

Martiene Riedijk*, Walter M. van den Bergh, Maarten van Vliet, Nuray Kusadasi, Lambert R. F. Span, Pieter R. Tuinman, M. Sesmu Arbous, Marcella C. A. Muller, HEMA-ICU Study Grp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

Objectives: Patients with haematological malignancies are at risk of concomitant critical neurological events warranting intensive care unit admission. We aimed to examine the characteristics and outcomes of this patient population, as more knowledge could facilitate decision making on ICU admission and treatment.

Design, setting and participants: A retrospective cohort study of 68 patients in adult ICUs of six Dutch university hospitals between 2003 and 2011.

Results: The median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 23 (IQR, 16-27), and 77% of patients needed mechanical ventilation within the first 24 hours of admission. Forty percent of patients had received an allogeneic stem cell transplantation, and 22% were neutropenic on admission. The most frequent underlying haematological condition was non-Hodgkin lymphoma (27%). Seizures were the most common neurological event for ICU admission (29%). The median ICU length of stay was 5 days (IQR, 1-13 days). ICU mortality (28%), hospital mortality (37%) and 3-month mortality (50%) were comparable with other studies of ICU patients with haematological malignancies. Factors associated with 3-month survival were baseline platelet count (113x10(9)/L in survivors v 39x10(9)/L in non-survivors, P <0.01) and APACHE II score (20 in survivors v 25 in non-survivors, P=0.02).

Conclusions: Patients with a history of haematological malignancy presenting with a critical neurological event have comparable survival rates with other patients with a haematologic malignancy admitted to the ICU. Our findings suggest that restrictions in ICU care are not justified for this patient population.

Original languageEnglish
Pages (from-to)268-273
Number of pages6
JournalCritical Care and Resuscitation
Volume17
Issue number4
Publication statusPublished - Dec-2015

Keywords

  • STEM-CELL TRANSPLANTATION
  • CRITICALLY-ILL PATIENTS
  • PLATELET-TRANSFUSION
  • NEUROCRITICAL CARE
  • CANCER-PATIENTS
  • CASE-FATALITY
  • RISK-FACTORS
  • SURVIVAL
  • MULTICENTER
  • SEIZURES

Cite this