Outcomes of Critically Ill Patients With Hematologic Malignancies: Prospective Multicenter Data From France and Belgium-A Groupe de Recherche Respiratoire en Reanimation Onco-Hematologique Study

被引：453

作者：

Azoulay, Elie ^{[1
]}

Mokart, Djamel ^{[5
]}

Pene, Frederic ^{[2
]}

Lambert, Jerome ^{[1
]}

Kouatchet, Achille ^{[6
]}

Mayaux, Julien ^{[3
]}

Vincent, Francois ^{[7
]}

Nyunga, Martine ^{[8
]}

Bruneel, Fabrice ^{[9
]}

Laisne, Louise-Marie ^{[1
]}

Rabbat, Antoine ^{[4
]}

Lebert, Christine ^{[10
]}

Perez, Pierre ^{[11
]}

Chaize, Marine ^{[1
]}

Renault, Anne ^{[12
]}

Meert, Anne-Pascale ^{[16
]}

Benoit, Dominique ^{[17
]}

Hamidfar, Rebecca ^{[13
]}

Jourdain, Merce ^{[14
]}

Darmon, Michael ^{[15
]}

Schlemmer, Benoit ^{[1
]}

Chevret, Sylvie ^{[1
]}

Lemiale, Virginie ^{[1
]}

机构：

[1] St Louis Hosp, Paris, France

[2] Cochin Hosp, Paris, France

[3] Hop La Pitie Salpetriere, Paris, France

[4] Hop Hotel Dieu, Paris, France

[5] Inst J Paoli I Calmettes, F-13009 Marseille, France

[6] Ctr Hosp Univ Hosp, Angers, France

[7] Avicenne Hosp, Bobigny, France

[8] Victor Provo Hosp, Roubaix, France

[9] Mignot Hosp, Versailles, France

[10] Montaigu Hosp, La Roche Sur Yon, France

[11] Brabois Hosp, Nancy, France

[12] Brest Hosp, Brest, France

[13] Albert Michallon Hosp, Grenoble, France

[14] Salengro Hosp, Lille, France

[15] Nord Hosp, St Etienne, France

[16] Inst Jules Bordet, B-1000 Brussels, Belgium

[17] Ghent Univ Hosp, Ghent, Belgium

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2013年 / 31卷 / 22期

关键词：

INTENSIVE-CARE-UNIT; ACUTE MYELOID-LEUKEMIA; REQUIRING MECHANICAL VENTILATION; STEM-CELL TRANSPLANTATION; ACUTE MONOCYTIC LEUKEMIA; TUMOR LYSIS SYNDROME; CANCER-PATIENTS; ORGAN FAILURE; PROGNOSTIC INDICATORS; NEUTROPENIC PATIENTS;

D O I：

10.1200/JCO.2012.47.2365

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose Patients with hematologic malignancies are increasingly admitted to the intensive care unit (ICU) when life-threatening events occur. We sought to report outcomes and prognostic factors in these patients. Patients and Methods Ours was a prospective, multicenter cohort study of critically ill patients with hematologic malignancies. Health-related quality of life (HRQOL) and disease status were collected after 3 to 6 months. Results Of the 1,011 patients, 38.2% had newly diagnosed malignancies, 23.1% were in remission, and 24.9% had received hematopoietic stem-cell transplantations (HSCT, including 145 allogeneic). ICU admission was mostly required for acute respiratory failure (62.5%) and/or shock (42.3%). On day1, 733 patients (72.5%) received life-supporting interventions. Hospital, day-90, and 1-year survival rates were 60.7%, 52.5%, and 43.3%, respectively. By multivariate analysis, cancer remission and time to ICU admission less than 24 hours were associated with better hospital survival. Poor performance status, Charlson comorbidity index, allogeneic HSCT, organ dysfunction score, cardiac arrest, acute respiratory failure, malignant organ infiltration, and invasive aspergillosis were associated with higher hospital mortality. Mechanical ventilation (47.9% of patients), vasoactive drugs (51.2%), and dialysis (25.9%) were associated with mortality rates of 60.5%, 57.5%, and 59.2%, respectively. On day 90, 80% of survivors had no HRQOL alterations (physical and mental health similar to that of the overall cancer population). After 6 months, 80% of survivors had no change in treatment intensity compared with similar patients not admitted to the ICU, and 80% were in remission. Conclusion Critically ill patients with hematologic malignancies have good survival, disease control, and post-ICU HRQOL. Earlier ICU admission is associated with better survival. (C) 2013 by American Society of Clinical Oncology

引用

页码：2810 / +

页数：12

共 55 条

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