Analysis of 206 oncohematological patients admitted to the intensive care unit

Antelo Guadalupe, Cosacow Cesar, Maymó Daniela, Laviano Julia, Rivero Equiza Tomas, Fornillo Florencia, Bonelli Ignacio, F. Jose
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Abstract

The Intensive Care Unit (ICU) provides support that includes oncohematology (OH) patients. There is tendency to delay admission of this patients to the unit. Currently, advances in the molecular biology of specific mutations; advances in stem cell transplant and immunotherapy have produced a change in the prognosis of patients. A descriptive, retrospective cohort study was carried out in adult patients with oncohematological diseases who were admitted to the ICU, in the period from January 2009 to February 2021 to evaluate mortality in the unit as the main objective as well as associations between epidemiological, clinical variables and others related to the oncohematological situation and mortality during this period. 206 patients were included. The median age was 59years (IQR: 46-68). The median on days of hospitalization was 15 (IQR: 8-28) whilst the median of days in the ICU was 5 (3-8). Mortality was evaluated at the time of discharge from the ICU, reaching 45% (93 patients), 47% at 30days and 49% at 60days, respectively. The median survival of the global population was 15.5days (IQR: 4.25-60). The median APACHE II scored 22 points (IQR: 15-25). A statistically significant relationship was found in the multivariate analysis for mortality with the APACHE II variables (p = 0.0001) and the requirement for mechanical ventilation (p = 0.021). Using the ROC curve method, the APACHE II score value of 22 was obtained as the point of greatest statistical significance. The log rank test method was used to compare patients with a value greater or less than 22. In conclusion, the value of 22 points scored on APACHE II and the requirement for mechanical ventilation served to discriminate between two groups of patients with different prognosis.
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重症监护病房206例血液肿瘤患者分析
重症监护病房(ICU)提供支持,包括肿瘤血液学(OH)患者。这类病人有延迟入院的倾向。目前,特异性突变的分子生物学研究进展;干细胞移植和免疫治疗的进展已经改变了患者的预后。对2009年1月至2021年2月期间入住ICU的成年血液病患者进行了一项描述性、回顾性队列研究,以评估该单元的死亡率为主要目标,以及流行病学、临床变量和其他与此期间血液病情况和死亡率相关的变量之间的关联。纳入206例患者。中位年龄59岁(IQR: 46-68)。住院天数中位数为15天(IQR: 8-28), ICU住院天数中位数为5天(3-8)。出院时的死亡率分别为45%(93例)、47%(30天)和49%(60天)。全球人群的中位生存期为15.5天(IQR: 4.25-60)。APACHE II的中位数得分为22分(IQR: 15-25)。在多变量分析中,死亡率与APACHE II变量(p = 0.0001)和机械通气需求(p = 0.021)存在统计学显著关系。采用ROC曲线法,得到APACHE II评分值22为最大统计学意义点。对数秩检验方法用于比较大于或小于22的患者。综上所述,APACHEⅱ评分22分及是否需要机械通气可作为两组患者预后差异的区分指标。
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