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

被引:3
作者
Yerzhan, Adina [1 ]
Razbekova, Madina [1 ]
Merenkov, Yevgeniy [2 ]
Khudaibergenova, Makhira [2 ]
Abdildin, Yerkin [3 ]
Sarria-Santamera, Antonio [1 ]
Viderman, Dmitriy [1 ,2 ]
机构
[1] Nazarbayev Univ Sch Med, Sch Med, 53 Kabanbay Batyr Ave, Astana 010000, Kazakhstan
[2] Natl Res Oncol Ctr, Dept Anesthesiol Intens Care & Pain Med, Astana 010000, Kazakhstan
[3] Nazarbayev Univ, Sch Engn & Digital Sci, Astana 010000, Kazakhstan
来源
MEDICINA-LITHUANIA | 2023年 / 59卷 / 02期
关键词
hematologic malignancies; hospital-acquired infections; sepsis; febrile neutropenia; chronic hepatitis; intensive care unit; mortality; HEPATITIS-B; MORTALITY; CANCER; SEPSIS; VIRUS;
D O I
10.3390/medicina59020214
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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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页数:9
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