Description

Bach et al identified prognostic factors associated with mortality in patients requiring mechanical ventilation after hematopoietic stem cell transplantation (HSCT). These can identify patients for whom continued therapy may be futile. The authors are from Memorial Sloan-Kettering Cancer Center, Mount Sinai Medical Center, City of Hope National Medical Center, the University of Arkansas, and the John L. McClellan Memorial VA Hospital in Little Rock.


 

Prognostic factors associated with mortality:

(1) hepatic dysfunction within 3 days of admission to ICU (total serum bilirubin > 4 mg/dL or > 68 µmol/L)

(2) renal dysfunction within 3 days of admission to ICU (serum creatinine > 2 mg/dL or > 177 µmol/L)

 

The presence of both prognostic factors was associated with 100% mortality (51 of 51 patients).

 

Additional risk factors for mortality:

(1) ventilation required for > 4 days

(2) vasopressors required for > 4 hours

(3) APACHE II score >= 29

 


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