Contributions
Abstract: PB2049
Type: Publication Only
Background
Patients who present oncohematological pathology require admission to the ICU at times. Generally this is due to two situations that can sometimes overlap. First, to treat pathologies secondary to their underlying disease, and second, due to complications of the treatment they receive.
Aims
The main objective is to analyze the prognosis of hematological patients who have required admission to the ICU, as well as to study the factors that can modify this prognosis.
Methods
This is a descriptive study of 90 oncohematological patients admitted to the ICU of our center between 2010 and 2015. The following data have been collected: sex, age, date of admission to the ICU, reason for admission to the ICU, baseline homeopathy and if it was active at the time of admission, necessity of mechanical invasive ventilation (MIV) and the number of days, death during admission, haematopoietic progenitor cell transplantation and type, existence of GVHD and neutropenia.
Results
Out of the total of 90 patients, 62 men (68%) and 28 women (32%) were registered. The average age of the patients was 53 years, with an age range of 20 to 83. The overall mortality at admission was 67% (60 patients), and if we divide it by sex we observed that the mortality in men was 69 % and in women of 64%. The most frequent hematological pathologies were: 32 patients had non-Hodgkin's lymphoma (35.5%); 19 acute myeloid leukemia, (21.1%); 9 Hodgkin's lymphoma (10%); 6 acute lymphoid leukemia (6.67%); 6 multiple myeloma (6.67%); 4 myelodysplastic syndrome (4.4%); 4 chronic lymphoid leukemia (4.4%); 2 chronic myeloid leukemia (2.2%); 2 polycythemia vera (2.2%). Finally, 1 patient with aplastic anemia, 1 with cardiac amyloidosis and 1 with intracranial plasmacytoma. There are 2 cases with unknown diagnosis. The most frequent causes that triggered the admission are (only or associated): acute respiratory failure, this pathology being the most frequent, since it is presented in 51 patients (56.67%), followed by infections in their different modalities corresponding to 26 patients (28.89%) and finally, heart failure, 9 patients (10%). The fact of requiring MIV was associated with a mortality of 71% (69 patients), a figure that rises to 74% if it is needed for a period of 7 or more days. Of the 26 patients who underwent transplantation of hematopoietic progenitors, 23 died, accounting for 88% of deaths (83% in autologous patients and 90% in allogeneic patients). Of the 61 patients who had their active homeopathy at the time of admission, 37 (60%) died, a figure that reaches 93% (14 out of 15) when they had a GVHD. A total of 34 patients presented neutropenia on admission to the ICU, and 82% died (28).
Conclusion
Patients with oncohematological diseases have a higher risk of presenting complications that require admission to the ICU. They also represent a type of patient with a high mortality after admission (overall mortality of 67%). According to our study, the situations that are linked to a higher mortality are: active GVHD (93% mortality), being a transplant recipient (88%), neutropenia (82%) and requiring MIV (71%).
Session topic: 31. Infectious diseases, supportive care
Keyword(s): Graft-versus-host disease (GVHD), Infection, Mortality, Risk factor
Abstract: PB2049
Type: Publication Only
Background
Patients who present oncohematological pathology require admission to the ICU at times. Generally this is due to two situations that can sometimes overlap. First, to treat pathologies secondary to their underlying disease, and second, due to complications of the treatment they receive.
Aims
The main objective is to analyze the prognosis of hematological patients who have required admission to the ICU, as well as to study the factors that can modify this prognosis.
Methods
This is a descriptive study of 90 oncohematological patients admitted to the ICU of our center between 2010 and 2015. The following data have been collected: sex, age, date of admission to the ICU, reason for admission to the ICU, baseline homeopathy and if it was active at the time of admission, necessity of mechanical invasive ventilation (MIV) and the number of days, death during admission, haematopoietic progenitor cell transplantation and type, existence of GVHD and neutropenia.
Results
Out of the total of 90 patients, 62 men (68%) and 28 women (32%) were registered. The average age of the patients was 53 years, with an age range of 20 to 83. The overall mortality at admission was 67% (60 patients), and if we divide it by sex we observed that the mortality in men was 69 % and in women of 64%. The most frequent hematological pathologies were: 32 patients had non-Hodgkin's lymphoma (35.5%); 19 acute myeloid leukemia, (21.1%); 9 Hodgkin's lymphoma (10%); 6 acute lymphoid leukemia (6.67%); 6 multiple myeloma (6.67%); 4 myelodysplastic syndrome (4.4%); 4 chronic lymphoid leukemia (4.4%); 2 chronic myeloid leukemia (2.2%); 2 polycythemia vera (2.2%). Finally, 1 patient with aplastic anemia, 1 with cardiac amyloidosis and 1 with intracranial plasmacytoma. There are 2 cases with unknown diagnosis. The most frequent causes that triggered the admission are (only or associated): acute respiratory failure, this pathology being the most frequent, since it is presented in 51 patients (56.67%), followed by infections in their different modalities corresponding to 26 patients (28.89%) and finally, heart failure, 9 patients (10%). The fact of requiring MIV was associated with a mortality of 71% (69 patients), a figure that rises to 74% if it is needed for a period of 7 or more days. Of the 26 patients who underwent transplantation of hematopoietic progenitors, 23 died, accounting for 88% of deaths (83% in autologous patients and 90% in allogeneic patients). Of the 61 patients who had their active homeopathy at the time of admission, 37 (60%) died, a figure that reaches 93% (14 out of 15) when they had a GVHD. A total of 34 patients presented neutropenia on admission to the ICU, and 82% died (28).
Conclusion
Patients with oncohematological diseases have a higher risk of presenting complications that require admission to the ICU. They also represent a type of patient with a high mortality after admission (overall mortality of 67%). According to our study, the situations that are linked to a higher mortality are: active GVHD (93% mortality), being a transplant recipient (88%), neutropenia (82%) and requiring MIV (71%).
Session topic: 31. Infectious diseases, supportive care
Keyword(s): Graft-versus-host disease (GVHD), Infection, Mortality, Risk factor