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Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy
OBJECTIVE: Despite advances in the field of oncology and intensive care, the outcomes of hematolymphoid malignancy (HLM) patients admitted to ICU are poor. This study was carried out to look at the demographic data, clinical features, and predictors of hospital mortality in these patients. MATERIALS...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Jaypee Brothers Medical Publishers
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874294/ https://www.ncbi.nlm.nih.gov/pubmed/33603303 http://dx.doi.org/10.5005/jp-journals-10071-23469 |
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author | Siddiqui, Suhail S Prabu, Natesh R Chaudhari, Harish K Narkhede, Amit M Sarode, Satish V Dhundi, Ujwal Divatia, Jigeeshu V Kulkarni, Atul P |
author_facet | Siddiqui, Suhail S Prabu, Natesh R Chaudhari, Harish K Narkhede, Amit M Sarode, Satish V Dhundi, Ujwal Divatia, Jigeeshu V Kulkarni, Atul P |
author_sort | Siddiqui, Suhail S |
collection | PubMed |
description | OBJECTIVE: Despite advances in the field of oncology and intensive care, the outcomes of hematolymphoid malignancy (HLM) patients admitted to ICU are poor. This study was carried out to look at the demographic data, clinical features, and predictors of hospital mortality in these patients. MATERIALS AND METHODS: We prospectively studied 101 adult critically ill patients with HLM admitted to the 14-bedded mixed medical surgical ICU of a tertiary care cancer center. Out of 101 patients, end-of-life care decisions were taken in 7 patients, who were excluded from the outcome analysis. Predictors of in-hospital mortality were evaluated using univariate and multivariate analysis. RESULTS: The ICU and in-hospital mortality recorded in our study were 48.9 and 54.3%, respectively. Neutropenia at ICU admission, Simplified Acute Physiology Score III (SAPS III) score, and mechanical ventilation (MV) within 24 hours of ICU admission were associated with in-hospital mortality on univariate analysis. On multivariate logistic regression analysis, neutropenia at ICU admission (OR 4.621; 95% CI, 1.2–17.357) and MV within 24 hours of ICU admission (OR 2.728; 95% CI, 1.077–6.912) were independent predictors of in-hospital mortality. CONCLUSION: The HLM patients needing critical care have high acuity of illness, and acute respiratory failure is the commonest reason for ICU admission in these patients. In our study, the ICU survival was more than 50% and more than 45% patients were discharged alive from the hospital. We found a need for MV within 24 hours of ICU admission and presence of neutropenia at ICU admission to be independent predictors of hospital mortality in our study. HOW TO CITE THIS ARTICLE: Siddiqui SS, Prabu NR, Chaudhari HK, Narkhede AM, Sarode SV, Dhundi U, et al. Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy. Indian J Crit Care Med 2021;25(1):56–61. |
format | Online Article Text |
id | pubmed-7874294 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-78742942021-02-17 Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy Siddiqui, Suhail S Prabu, Natesh R Chaudhari, Harish K Narkhede, Amit M Sarode, Satish V Dhundi, Ujwal Divatia, Jigeeshu V Kulkarni, Atul P Indian J Crit Care Med Research Article OBJECTIVE: Despite advances in the field of oncology and intensive care, the outcomes of hematolymphoid malignancy (HLM) patients admitted to ICU are poor. This study was carried out to look at the demographic data, clinical features, and predictors of hospital mortality in these patients. MATERIALS AND METHODS: We prospectively studied 101 adult critically ill patients with HLM admitted to the 14-bedded mixed medical surgical ICU of a tertiary care cancer center. Out of 101 patients, end-of-life care decisions were taken in 7 patients, who were excluded from the outcome analysis. Predictors of in-hospital mortality were evaluated using univariate and multivariate analysis. RESULTS: The ICU and in-hospital mortality recorded in our study were 48.9 and 54.3%, respectively. Neutropenia at ICU admission, Simplified Acute Physiology Score III (SAPS III) score, and mechanical ventilation (MV) within 24 hours of ICU admission were associated with in-hospital mortality on univariate analysis. On multivariate logistic regression analysis, neutropenia at ICU admission (OR 4.621; 95% CI, 1.2–17.357) and MV within 24 hours of ICU admission (OR 2.728; 95% CI, 1.077–6.912) were independent predictors of in-hospital mortality. CONCLUSION: The HLM patients needing critical care have high acuity of illness, and acute respiratory failure is the commonest reason for ICU admission in these patients. In our study, the ICU survival was more than 50% and more than 45% patients were discharged alive from the hospital. We found a need for MV within 24 hours of ICU admission and presence of neutropenia at ICU admission to be independent predictors of hospital mortality in our study. HOW TO CITE THIS ARTICLE: Siddiqui SS, Prabu NR, Chaudhari HK, Narkhede AM, Sarode SV, Dhundi U, et al. Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy. Indian J Crit Care Med 2021;25(1):56–61. Jaypee Brothers Medical Publishers 2021-01 /pmc/articles/PMC7874294/ /pubmed/33603303 http://dx.doi.org/10.5005/jp-journals-10071-23469 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. © Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Siddiqui, Suhail S Prabu, Natesh R Chaudhari, Harish K Narkhede, Amit M Sarode, Satish V Dhundi, Ujwal Divatia, Jigeeshu V Kulkarni, Atul P Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy |
title | Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy |
title_full | Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy |
title_fullStr | Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy |
title_full_unstemmed | Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy |
title_short | Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy |
title_sort | epidemiology, clinical characteristics, and prognostic factors in critically ill patients with hematolymphoid malignancy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874294/ https://www.ncbi.nlm.nih.gov/pubmed/33603303 http://dx.doi.org/10.5005/jp-journals-10071-23469 |
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