Mortality of Oncohematological Patients Undergoing Hematopoietic Stem Cell Transplantation Admitted to the Intensive Care Unit

Palomo, Y Corcia; Asorey, T Knight; Espigado, Ildefonso; Villén, L. Martín; Garnacho-Montero, José

doi:10.1016/j.transproceed.2015.09.033

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…After HSCT, initiation of MV is associated with low survival rates [17]. Corcia et al [18] reported that among patients who received HSCT treatment, 11% needed ICU treatment, with 83.3% of those patients dying in the ICU and 91.7% dying in the hospital. All patients who required invasive MV died in the ICU [18].…”

Section: Discussionmentioning

confidence: 99%

“…Corcia et al [18] reported that among patients who received HSCT treatment, 11% needed ICU treatment, with 83.3% of those patients dying in the ICU and 91.7% dying in the hospital. All patients who required invasive MV died in the ICU [18]. In our study, 10 patients received HSCT before ECMO, and the ECMO weaning rate of those patients was 30%.…”

Section: Discussionmentioning

confidence: 99%

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Extracorporeal Life Support in Adult Patients with Hematologic Malignancies and Acute Circulatory and/or Respiratory Failure

Cho

Lim

et al. 2019

Korean J Thorac Cardiovasc Surg

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Background The primary goal of this study was to characterize the clinical outcomes of adult patients with hematologic malignancies (HM) who were treated with extracorporeal membrane oxygenation (ECMO) support when conventional treatments failed. Methods In this retrospective, observational study at a tertiary medical center, we reviewed the clinical course of 23 consecutive patients with HM requiring ECMO who were admitted to the intensive care unit at Asan Medical Center from March 2010 to April 2015. Results A total of 23 patients (8 female; median age, 44 years; range, 29–51 years) with HM and severe acute circulatory and/or respiratory failure received ECMO therapy during the study period. Fourteen patients received veno-arterial ECMO, while 9 patients received veno-venous ECMO. The median ECMO duration was 104.7 hours (range, 37.1–221 hours). Nine patients were successfully weaned from ECMO. The in-hospital mortality rate was 91.1% (21 of 23). There were complications in 3 patients (cannulation site bleeding, limb ischemia, and gastrointestinal bleeding). Conclusion ECMO is a useful treatment for patients with circulatory and/or pulmonary failure. However, in patients with HM, the outcomes of ECMO treatment results were very poor, so it is advisable to carefully decide whether to apply ECMO to these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Extracorporeal Life Support in Adult Patients with Hematologic Malignancies and Acute Circulatory and/or Respiratory Failure

Cho

Lim

et al. 2019

Korean J Thorac Cardiovasc Surg

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“…More recently, their survival has improved, but mortality still remains high . The reported hospital mortality of patients in studies that were published after 2010 is in the range from 63% to 83% . Long‐term survival is uniformly poor, with reported 1‐year survival rates in recent publications ranging from 15% to 19% .…”

Section: Icu Referral Of Critically Ill Patients With Cancermentioning

confidence: 99%

Critical care of patients with cancer

Shimabukuro‐Vornhagen

Böll

Kochanek

et al. 2016

CA A Cancer J Clinicians

115

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Answer questions and earn CME/CNE The increasing prevalence of patients living with cancer in conjunction with the rapid progress in cancer therapy will lead to a growing number of patients with cancer who will require intensive care treatment. Fortunately, the development of more effective oncologic therapies, advances in critical care, and improvements in patient selection have led to an increased survival of critically ill patients with cancer. As a consequence, critical care has become an important cornerstone in the continuum of modern cancer care. Although, in many aspects, critical care for patients with cancer does not differ from intensive care for other seriously ill patients, there are several challenging issues that are unique to this patient population and require special knowledge and skills. The optimal management of critically ill patients with cancer necessitates expertise in oncology, critical care, and palliative medicine. Cancer specialists therefore have to be familiar with key principles of intensive care for critically ill patients with cancer. This review provides an overview of the state-of-the-art in the individualized management of critically ill patients with cancer. CA Cancer J Clin 2016. © 2016 American Cancer Society.

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“…Nowadays, ICU patients with a solid malignancy have similar mortality when compared to ICU patients without a malignancy [ 7 ]. Although the reported mortality of ICU patients with a hematological malignancy varies [ 8 – 10 ], a decrease in mortality over the years has been described [ 5 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study

et al. 2021

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Introduction Given clinicians’ frequent concerns about unfavourable outcomes, Intensive Care Unit (ICU) triage decisions in acutely ill cancer patients can be difficult, as clinicians may have doubts about the appropriateness of an ICU admission. To aid to this decision making, we studied the survival and performance status of cancer patients 2 years following an unplanned ICU admission. Materials and methods This was a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned ICU admission in 2017 into two groups: patients with or without an active malignancy. Descriptive statistics, Pearson’s Chi-square tests and the Mann-Whitney U tests were used to evaluate the primary objective 2-year mortality and performance status. A good performance status was defined as ECOG performance status 0 (fully active) or 1 (restricted in physically strenuous activity but ambulatory and able to carry out light work). A multivariable binary logistic regression analysis was used to identify factors associated with 2-year mortality within cancer patients. Results Of the 1046 unplanned ICU admissions, 125 (12%) patients had cancer. The 2-year mortality in patients with cancer was significantly higher than in patients without cancer (72% and 42.5%, P <0.001). The median performance status at 2 years in cancer patients was 1 (IQR 0–2). Only an ECOG performance status of 2 (OR 8.94; 95% CI 1.21–65.89) was independently associated with 2-year mortality. Conclusions In our study, the majority of the survivors have a good performance status 2 years after ICU admission. However, at that point, three-quarter of these cancer patients had died, and mortality in cancer patients was significantly higher than in patients without cancer. ICU admission decisions in acutely ill cancer patients should be based on performance status, severity of illness and long-term prognosis, and this should be communicated in the shared decision making. An ICU admission decision should not solely be based on the presence of a malignancy.

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Mortality of Oncohematological Patients Undergoing Hematopoietic Stem Cell Transplantation Admitted to the Intensive Care Unit

Cited by 7 publications

References 4 publications

Extracorporeal Life Support in Adult Patients with Hematologic Malignancies and Acute Circulatory and/or Respiratory Failure

Extracorporeal Life Support in Adult Patients with Hematologic Malignancies and Acute Circulatory and/or Respiratory Failure

Critical care of patients with cancer

Assessment of mortality and performance status in critically ill cancer patients: A retrospective cohort study

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