Trinkaus et al reported predictors associated with mortality following admission to the intensive care unit (ICU) for a patient following an autologous hematopoietic stem cell transplant. These can help to identify a patient who may require more aggressive management. The authors are from the University of Toronto, Princess Margaret Hospital, Mount Sinai Hospital (Toronto) and Mayo Clinic in Scottsdale.
Patient selection: autologous hematopoietic cell transplant admitted to the ICU
The frequency of ICU admission after the transplant was low (overall 3%).
The underlying diagnosis with the highest risk was AL amyloidosis at 28%.
The lowest was Hodgkin's disease at 1%.
Predictors of mortality:
(1) SOFA score during the first 24 hours (12.7 +/- 4.8 in nonsurvivors; 8.1 +/- 3.6 in survivors)
(2) APACHE II score during the first 24 hours (29.7 +/- 8.1 in nonsurvivors; 18.4 +/- 4 for survivors)
(3) multi-organ (>= 2) failure
(4) mechanical ventilation
(5) inotropic support > 4 hours
(6) Gram-negative sepsis
where:
• These risk factors overlap (mechanical ventilation indicates respiratory failure, which increases SOFA and APACHE II scores).
To read more or access our algorithms and calculators, please log in or register.
