TY - JOUR

T1 - Prognosis of Allogeneic Haematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit

T2 - A Retrospective, Single-Centre Study

AU - Lindgaard, Sidsel Christy

AU - Nielsen, Jonas

AU - Lindmark, Anders

AU - Sengeløv, Henrik

N1 - © 2015 S. Karger AG, Basel.

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Allogeneic haematopoietic stem cell transplantation (HSCT) is a procedure with inherent complications and intensive care may be necessary. We evaluated the short- and long-term outcomes of the HSCT recipients requiring admission to the intensive care unit (ICU).METHODS: We retrospectively examined the outcome of 54 adult haematological HSCT recipients admitted to the ICU at the University Hospital Rigshospitalet between January 2007 and March 2012.RESULTS: The overall in-ICU, in-hospital, 6-month and 1-year mortality rates were 46.3, 75.9, 79.6 and 86.5%, respectively. Mechanical ventilation had a statistically significant effect on in-ICU (p = 0.02), 6-month (p = 0.049) and 1-year (p = 0.014) mortality. Renal replacement therapy also had a statistically significant effect on in-hospital (p = 0.038) and 6-month (p = 0.026) mortality. Short ICU admissions, i.e. <10 days, had a statistically significant positive effect on in-hospital, 6-month and 1-year mortality (all p < 0.001). The SAPS II, APACHE II and SOFA scoring systems grossly underestimated the actual in-hospital mortality observed for these patients.CONCLUSION: The poor prognosis of critically ill HSCT recipients admitted to the ICU was confirmed in our study. Mechanical ventilation, renal replacement therapy and an ICU admission of ≥10 days were each risk factors for mortality in the first year after ICU admission.

AB - BACKGROUND: Allogeneic haematopoietic stem cell transplantation (HSCT) is a procedure with inherent complications and intensive care may be necessary. We evaluated the short- and long-term outcomes of the HSCT recipients requiring admission to the intensive care unit (ICU).METHODS: We retrospectively examined the outcome of 54 adult haematological HSCT recipients admitted to the ICU at the University Hospital Rigshospitalet between January 2007 and March 2012.RESULTS: The overall in-ICU, in-hospital, 6-month and 1-year mortality rates were 46.3, 75.9, 79.6 and 86.5%, respectively. Mechanical ventilation had a statistically significant effect on in-ICU (p = 0.02), 6-month (p = 0.049) and 1-year (p = 0.014) mortality. Renal replacement therapy also had a statistically significant effect on in-hospital (p = 0.038) and 6-month (p = 0.026) mortality. Short ICU admissions, i.e. <10 days, had a statistically significant positive effect on in-hospital, 6-month and 1-year mortality (all p < 0.001). The SAPS II, APACHE II and SOFA scoring systems grossly underestimated the actual in-hospital mortality observed for these patients.CONCLUSION: The poor prognosis of critically ill HSCT recipients admitted to the ICU was confirmed in our study. Mechanical ventilation, renal replacement therapy and an ICU admission of ≥10 days were each risk factors for mortality in the first year after ICU admission.

KW - Adolescent

KW - Adult

KW - Aged

KW - Critical Illness

KW - Female

KW - Graft vs Host Disease

KW - Hematopoietic Stem Cell Transplantation

KW - Hematopoietic Stem Cells

KW - Hospital Mortality

KW - Hospitals, University

KW - Humans

KW - Intensive Care Units

KW - Lymphoma

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Renal Replacement Therapy

KW - Retrospective Studies

KW - Transplantation, Homologous

KW - Young Adult

U2 - 10.1159/000440937

DO - 10.1159/000440937

M3 - Journal article

C2 - 26512978

VL - 135

SP - 72

EP - 78

JO - Acta Haematologica

JF - Acta Haematologica

SN - 0001-5792

IS - 2

ER -