Objective: Patients with hematologic diseases can have increased life expectancy with newly developed chemotherapeutic agents, hematopoietic stem-cell transplantation, and further supportive therapy. However, intensive therapies lead to more life-threatening complications that require intensive care unit (ICU) admission. Therefore, understanding the factors affecting mortality is important when accepting these patients to the ICU. This study was conducted to explore the factors affecting the mortality of patients admitted to medical ICUs with a diagnosis of hematologic disease.
Materials and Methods: The medical records of patients with diagnoses of hematologic diseases hospitalized in the medical ICU between March 2013 and March 2019 were retrospectively reviewed. Age, gender, subgroup of hematologic disease, APACHE II scores, admission diagnoses, mechanical ventilation requirement, renal replacement therapy, vasopressor therapy, and ICU and hospital outcomes were recorded. The factors affecting mortality were evaluated.
Results: Patients with acute leukemia [29 (30%)], multiple myeloma [20 (21%)], lymphoma [22 (23%)], chronic leukemia [8 (9%)], and other hematologic diseases [15 (16%)] were identified and included during the 6-year study period. The median age of patients was 60 (27.5) years, and 50 (53%) patients were women. Bone marrow transplantation was performed in 20% of patients, and 75 (79%) patients required invasive mechanical ventilation. Vasopressor treatment was required in 49 (52%) of patients. The mortality rate was 55%. APACHE II scores were higher in nonsurvivors. Moreover, they required more mechanical ventilation, vasopressor treatment, and renal replacement therapy. According to regression analysis, high APACHE II scores, vasopressor therapy requirement, and presence of respiratory failure were the risk factors for mortality.
Conclusion: High APACHE II scores, need for vasopressor therapy, and respiratory failure were identified as independent risk factors for mortality in patients with hematologic diseases admitted to the medical ICU.