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Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections

Background and objectives: Patients admitted to the intensive care unit (ICU) have an increased risk of hospital-acquired infection (HAI). A diagnosis of cancer alone increases the risk of sepsis three–five-fold, which further increases the risk of nosocomial infection, subsequently deteriorates res...

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Autores principales: Yerzhan, Adina, Razbekova, Madina, Merenkov, Yevgeniy, Khudaibergenova, Makhira, Abdildin, Yerkin, Sarria-Santamera, Antonio, Viderman, Dmitriy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960080/
https://www.ncbi.nlm.nih.gov/pubmed/36837416
http://dx.doi.org/10.3390/medicina59020214
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author Yerzhan, Adina
Razbekova, Madina
Merenkov, Yevgeniy
Khudaibergenova, Makhira
Abdildin, Yerkin
Sarria-Santamera, Antonio
Viderman, Dmitriy
author_facet Yerzhan, Adina
Razbekova, Madina
Merenkov, Yevgeniy
Khudaibergenova, Makhira
Abdildin, Yerkin
Sarria-Santamera, Antonio
Viderman, Dmitriy
author_sort Yerzhan, Adina
collection PubMed
description Background and objectives: Patients admitted to the intensive care unit (ICU) have an increased risk of hospital-acquired infection (HAI). A diagnosis of cancer alone increases the risk of sepsis three–five-fold, which further increases the risk of nosocomial infection, subsequently deteriorates results, and leads to high mortality. In this study, we aimed to assess the mortality rate among hematologic oncologic patients with suspected infection who were subsequently admitted to the ICU and the predictive factors that are associated with high ICU mortality. Materials and Methods: This retrospective cohort study was conducted in the hematological oncology critical care unit of a tertiary care hospital between November 2017 and February 2021. We analyzed anonymized medical records of hospitalized hematologic oncologic patients who were suspected or proven to have infection in the hematology-oncology department and were subsequently transferred to the ICU. Results: Both shorter hospitalization and shorter ICU stay length were observed in survivors [9.2 (7.7–10.4)] vs. non-survivors [10 (9.1–12.9), p = 0.004]. Sepsis had the highest hazard ratio (7.38) among all other factors, as patients with sepsis had higher mortality rates (98% among ICU non-survivors and 57% among ICU survivors) than those who had febrile neutropenia. Conclusions: The overall ICU mortality in patients with hematologic malignancies was 66%. Sepsis had the highest hazard ratio among all other predictive factors, as patients with sepsis had higher mortality rates than those who had febrile neutropenia. Chronic hepatitis (HBV and HCV) was significantly associated with higher ICU mortality.
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spelling pubmed-99600802023-02-26 Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections Yerzhan, Adina Razbekova, Madina Merenkov, Yevgeniy Khudaibergenova, Makhira Abdildin, Yerkin Sarria-Santamera, Antonio Viderman, Dmitriy Medicina (Kaunas) Article Background and objectives: Patients admitted to the intensive care unit (ICU) have an increased risk of hospital-acquired infection (HAI). A diagnosis of cancer alone increases the risk of sepsis three–five-fold, which further increases the risk of nosocomial infection, subsequently deteriorates results, and leads to high mortality. In this study, we aimed to assess the mortality rate among hematologic oncologic patients with suspected infection who were subsequently admitted to the ICU and the predictive factors that are associated with high ICU mortality. Materials and Methods: This retrospective cohort study was conducted in the hematological oncology critical care unit of a tertiary care hospital between November 2017 and February 2021. We analyzed anonymized medical records of hospitalized hematologic oncologic patients who were suspected or proven to have infection in the hematology-oncology department and were subsequently transferred to the ICU. Results: Both shorter hospitalization and shorter ICU stay length were observed in survivors [9.2 (7.7–10.4)] vs. non-survivors [10 (9.1–12.9), p = 0.004]. Sepsis had the highest hazard ratio (7.38) among all other factors, as patients with sepsis had higher mortality rates (98% among ICU non-survivors and 57% among ICU survivors) than those who had febrile neutropenia. Conclusions: The overall ICU mortality in patients with hematologic malignancies was 66%. Sepsis had the highest hazard ratio among all other predictive factors, as patients with sepsis had higher mortality rates than those who had febrile neutropenia. Chronic hepatitis (HBV and HCV) was significantly associated with higher ICU mortality. MDPI 2023-01-22 /pmc/articles/PMC9960080/ /pubmed/36837416 http://dx.doi.org/10.3390/medicina59020214 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yerzhan, Adina
Razbekova, Madina
Merenkov, Yevgeniy
Khudaibergenova, Makhira
Abdildin, Yerkin
Sarria-Santamera, Antonio
Viderman, Dmitriy
Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections
title Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections
title_full Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections
title_fullStr Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections
title_full_unstemmed Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections
title_short Risk Factors and Outcomes in Critically Ill Patients with Hematological Malignancies Complicated by Hospital-Acquired Infections
title_sort risk factors and outcomes in critically ill patients with hematological malignancies complicated by hospital-acquired infections
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960080/
https://www.ncbi.nlm.nih.gov/pubmed/36837416
http://dx.doi.org/10.3390/medicina59020214
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