Patient selection: critically-ill patient with a hematologic malignancy
Factors associated with a better outcome:
(1) hematologic malignancy in partial or complete remission
(2) time to ICU admission after hospital admission less than 24 hours
Factors associated with a worse outcome:
(1) poor performance status (completely disabled, bedridden) prior to critical illness
(2) high Charlson comorbidity index (significant comorbid conditions)
(3) allogeneic hematopoietic stem cell transplant (HSCT) or bone marrow transplant (BMT)
(4) multiple organ failure based on SOFA score on admission (SOFA ranges from 0 to 24 with odds ratio 1.21 per point without imputation)
(5) admission after cardiac arrest
(6) admission for acute respiratory failure (see mechanical ventilation, below)
(7) organ infiltration by the hematologic malignancy (not present with remission)
(8) invasive Aspergillosis
Interventions (indicative of organ failure) associated with mortality rates of about 60%:
(1) mechanical ventilation
(2) vasoactive drugs (vasopressors)
(3) dialysis
If the person was able to survive the hospital admission then outcomes at 6 months were good. The trick is surviving the hospital admission.
