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Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey

BACKGROUND/AIM: Patients with hematological malignancies (HM) often require admission to the intensive care unit (ICU) due to organ failure, disease progression or treatment-related complications, and they generally have a poor prognosis. Therefore, understanding the factors affecting ICU mortality...

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Autores principales: AYGENCEL, Gülbin, GÖKÇE, Onur, HAŞİMOĞLU, Merve, BOYACI DÜNDAR, Nazlıhan, TÜRKOĞLU, Melda, YEĞİN, Zeynep Arzu, ÖZKURT, Zübeyde Nur, YAĞCI, Münci
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific and Technological Research Council of Turkey (TUBITAK) 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387870/
https://www.ncbi.nlm.nih.gov/pubmed/36945922
http://dx.doi.org/10.55730/1300-0144.5590
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author AYGENCEL, Gülbin
GÖKÇE, Onur
HAŞİMOĞLU, Merve
BOYACI DÜNDAR, Nazlıhan
TÜRKOĞLU, Melda
YEĞİN, Zeynep Arzu
ÖZKURT, Zübeyde Nur
YAĞCI, Münci
author_facet AYGENCEL, Gülbin
GÖKÇE, Onur
HAŞİMOĞLU, Merve
BOYACI DÜNDAR, Nazlıhan
TÜRKOĞLU, Melda
YEĞİN, Zeynep Arzu
ÖZKURT, Zübeyde Nur
YAĞCI, Münci
author_sort AYGENCEL, Gülbin
collection PubMed
description BACKGROUND/AIM: Patients with hematological malignancies (HM) often require admission to the intensive care unit (ICU) due to organ failure, disease progression or treatment-related complications, and they generally have a poor prognosis. Therefore, understanding the factors affecting ICU mortality in HM patients is important. In this study, we aimed to identify the risk factors for ICU mortality in our critically ill HM patients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of HM patients who were hospitalized in our medical ICU between January 1, 2010 and December 31, 2018. We recorded some parameters of these patients and compared these parameters by statistically between survivors and nonsurvivors to determine the risk factors for ICU mortality. RESULTS: The study included 368 critically ill HM patients who were admitted to our medical ICU during a 9-year period. The median age was 58 (49–67) years and 63.3% of the patients were male. Most of the patients (43.2%) had acute leukemia. Hematopoietic stem cell transplantation (HSCT) was performed in 153 (41.6%) patients. The ICU mortality rate was 51.4%. According to univariable analyses, a lot of parameters (e.g., admission APACHE II and SOFA scores, length of ICU stay, some laboratory parameters at the ICU admission, the reason for ICU admission, comorbidities, type of HM, type of HSCT, infections on ICU admission and during ICU stay, etc.) were significantly different between survivors and nonsurvivors. However, only high SOFA scores at ICU admission (OR:1.281, p = 0.004), presence of septic shock (OR:17.123, p = 0.0001), acute kidney injury (OR:48.284, p = 0.0001), and requirement of invasive mechanical ventilation support during ICU stay (OR:23.118, p = 0.0001) were independent risk factors for ICU mortality. CONCLUSION: In our cohort, critically ill HM patients had high ICU mortality. We found four independent predictors for ICU mortality. Yet, there is still a need for further research to better understand poor outcome predictors in critically ill HM patients.
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spelling pubmed-103878702023-08-01 Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey AYGENCEL, Gülbin GÖKÇE, Onur HAŞİMOĞLU, Merve BOYACI DÜNDAR, Nazlıhan TÜRKOĞLU, Melda YEĞİN, Zeynep Arzu ÖZKURT, Zübeyde Nur YAĞCI, Münci Turk J Med Sci Research Article BACKGROUND/AIM: Patients with hematological malignancies (HM) often require admission to the intensive care unit (ICU) due to organ failure, disease progression or treatment-related complications, and they generally have a poor prognosis. Therefore, understanding the factors affecting ICU mortality in HM patients is important. In this study, we aimed to identify the risk factors for ICU mortality in our critically ill HM patients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of HM patients who were hospitalized in our medical ICU between January 1, 2010 and December 31, 2018. We recorded some parameters of these patients and compared these parameters by statistically between survivors and nonsurvivors to determine the risk factors for ICU mortality. RESULTS: The study included 368 critically ill HM patients who were admitted to our medical ICU during a 9-year period. The median age was 58 (49–67) years and 63.3% of the patients were male. Most of the patients (43.2%) had acute leukemia. Hematopoietic stem cell transplantation (HSCT) was performed in 153 (41.6%) patients. The ICU mortality rate was 51.4%. According to univariable analyses, a lot of parameters (e.g., admission APACHE II and SOFA scores, length of ICU stay, some laboratory parameters at the ICU admission, the reason for ICU admission, comorbidities, type of HM, type of HSCT, infections on ICU admission and during ICU stay, etc.) were significantly different between survivors and nonsurvivors. However, only high SOFA scores at ICU admission (OR:1.281, p = 0.004), presence of septic shock (OR:17.123, p = 0.0001), acute kidney injury (OR:48.284, p = 0.0001), and requirement of invasive mechanical ventilation support during ICU stay (OR:23.118, p = 0.0001) were independent risk factors for ICU mortality. CONCLUSION: In our cohort, critically ill HM patients had high ICU mortality. We found four independent predictors for ICU mortality. Yet, there is still a need for further research to better understand poor outcome predictors in critically ill HM patients. Scientific and Technological Research Council of Turkey (TUBITAK) 2022-11-01 /pmc/articles/PMC10387870/ /pubmed/36945922 http://dx.doi.org/10.55730/1300-0144.5590 Text en © TÜBİTAK https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Research Article
AYGENCEL, Gülbin
GÖKÇE, Onur
HAŞİMOĞLU, Merve
BOYACI DÜNDAR, Nazlıhan
TÜRKOĞLU, Melda
YEĞİN, Zeynep Arzu
ÖZKURT, Zübeyde Nur
YAĞCI, Münci
Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey
title Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey
title_full Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey
title_fullStr Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey
title_full_unstemmed Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey
title_short Risk factors for ICU mortality in patients with hematological malignancies: a single-center, retrospective cohort study from Turkey
title_sort risk factors for icu mortality in patients with hematological malignancies: a single-center, retrospective cohort study from turkey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387870/
https://www.ncbi.nlm.nih.gov/pubmed/36945922
http://dx.doi.org/10.55730/1300-0144.5590
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