Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study.
Cecilie Velsoe MaengChristian Fynbo ChristiansenKathleen Dori LiuPeter KamperSteffen ChristensenBruno C MedeirosLene Sofie Granfeldt ØstgårdPublished in: Leukemia & lymphoma (2022)
Identifying risk factors for intensive care unit (ICU) admission in acute leukemia (AL) patients may guide decision-making and improve prognosis. We included all adult AL patients receiving high-intensive chemotherapy in Denmark from 2005 to 2016. We examined risk factors [crude and adjusted (a) relative risks (RRs) with 95% confidence intervals (CI)] and calculated RRs of death after 1-, 3-, and 5-years in ICU-admitted patients compared with matched cohorts. In 1417 AML and 306 ALL patients, the 1-year risk of ICU admission was 28.1% for AML and 26.4% for ALL patients, with the majority related to the first course of chemotherapy. Performance status >1 was associated with increased risk. The 1-year mortality was higher in ICU-admitted patients (AML: 69.7 <i>vs.</i> 35.0% [aRR 2.74;CI = 2.17-3.47]; ALL 65.0 <i>vs.</i> 20.0% [aRR 3.04;CI = 1.54-6.02]). The excess mortality decreased with time. In this study, performance status was associated with increased risk of ICU admission and identifies high-risk patients. ICU admission was associated with high mortality, especially within the first year.
Keyphrases
- intensive care unit
- end stage renal disease
- ejection fraction
- newly diagnosed
- risk factors
- emergency department
- prognostic factors
- mechanical ventilation
- peritoneal dialysis
- cardiovascular disease
- decision making
- cardiovascular events
- risk assessment
- radiation therapy
- patient reported outcomes
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- allogeneic hematopoietic stem cell transplantation
- patient reported