Improved survival rates of AML patients following admission to the intensive care unit

被引:9
作者
Fassbind, Priska [1 ]
Jeker, Barbara [1 ]
Mueller, Beatrice U. [2 ]
Bacher, Ulrike [3 ]
Zimmerli, Stefan [4 ]
Endrich, Olga [5 ]
Gahl, Brigitta [6 ]
Novak, Urban [1 ]
Pabst, Thomas [1 ]
机构
[1] Univ Bern, Inselspital, Univ Hosp Bern, Dept Med Oncol, CH-3010 Bern, Switzerland
[2] Univ Bern, Inselspital, Univ Hosp Bern, Dept Biomed Res, Bern, Switzerland
[3] Univ Bern, Inselspital, Univ Hosp Bern, Dept Hematol, Bern, Switzerland
[4] Univ Bern, Inselspital, Univ Hosp Bern, Dept Infect Dis, Bern, Switzerland
[5] Univ Bern, Inselspital, Univ Hosp Bern, Dept Med, Bern, Switzerland
[6] Univ Bern, Inselspital, Univ Hosp Bern, Clin Trial Unit Bern, Bern, Switzerland
关键词
AML; ICU; intensive care; intensive treatment; outcome; prognosis; survival; ACUTE MYELOID-LEUKEMIA; CRITICALLY-ILL PATIENTS; PROGNOSTIC-FACTORS; HEMATOLOGICAL MALIGNANCY; CANCER-PATIENTS; VENTILATED PATIENTS; OUTCOMES; MORTALITY; CHEMOTHERAPY; MANAGEMENT;
D O I
10.1080/10428194.2019.1594213
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Induction chemotherapy in AML patients may have life-threatening side effects requiring intensive care unit (ICU) treatment. We analyzed all AML patients receiving intensive chemotherapy at a single academic center between 01/2006-12/2016. At least one ICU admission was observed in 32% (76/240) patients, and 33% of those died following ICU admission. Whereas the ICU admission proportion remained stable, mortality after ICU admission decreased from 14% (2006?2008) to 3% (2014?2016; p?=?.056). The number of failing organ systems inversely correlated with surviving ICU admission (p?<?.001). Sepsis and renal, cardiac and pulmonary failure were each associated with higher mortality. With increasing ICU duration, survival probability decreased (p?<?.001), but remained >50% even after 14 days of ICU treatment. Progression-free and overall survival were comparable between ICU surviving patients and patients never needing ICU support. In conclusion, outcome after ICU admission of AML patients has substantially improved in recent years.
引用
收藏
页码:2423 / 2431
页数:9
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