Bernal et al identified factors associated with poor survival for a patient with a hematological malignancy following discharge from the intensive care unit (ICU). These can help to identify patients who may benefit from more aggressive management. The authors are from multiple hospitals in Spain.


Patient selection: hematologic malignancy and discharged from ICU

Reasons for ICU admission: most often acute respiratory failure, sepsis and/or shock

The mortality rate in ICU was 61% (99 of 161).


Median survival after discharge: 18 months (range 1 to 54 months)


Risk factors for mortality from multi-variate model:

(1) ECOG score 3 or 4 (> 2) at ICU discharge (harzard ratio 11.1)

(2) relapse of hematologic malignancy (hazard ratio 9.7)

(3) discontinuation of planned treatment of the hematologic malignancy (hazard ratio 4.3)


Risk factors for discontinuation of planned treatment:

(1) high APACHE II score

(2) high ECOG score

(3) absence of stem cell transplant (i.e., stem cell transplant reduces the risk)


The severity of comorbid conditions affects survival during and after an ICU admission.


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