Supervivencia de los pacientes con hemopatías ingresados en una Unidad de Medicina Intensiva. Estudio de 16 años / Survival of haematologic patients admitted to an Intensive Care Unit. A 16 years study

Fundamento y objetivo: La supervivencia de los pacientes hematológicos en las unidades de Cuidados Intensivos (UCI) es tan escasa que cabe preguntarse si está indicado o no su ingreso en ellas. El objetivo de este estudio fue averiguar la supervivencia de estos pacientes en una UCI para saber si su ingreso está justificado. Pacientes y método: Estudio retrospectivo de 600 pacientes hematológicos (media [DE] de edad de 49,4 [16,4] años, 58,3% varones) que suman 660 ingresos en la UCI de un hospital universitario, con seguimiento a los 6 meses. Las enfermedades hematológicas fueron: leucemia (50,5%), linfoma (18,7%), mieloma (10,0%), síndrome mielodisplásico (4,2%), anemia aplásica o aplasia medular (3,3%), microangiopatías trombóticas y síndrome HELLP (7,4%), y otras. Resultados: Sobrevivió el 37,5% de los pacientes. La supervivencia de las microangiopatías trombóticas y síndrome HELLP fue mayor (81,8% de los pacientes) que la de las leucemias (26,6%) y linfomas (49,1%). La supervivencia cuando el motivo de ingreso fue insuficiencia respiratoria con o sin shock séptico (20 y 27% de los ingresos respectivamente) fue menor que cuando fue únicamente por shock séptico (58,7%). La supervivencia de los pacientes sometidos a ventilación mecánica fue del 14,6%, a depuración extrarrenal del 32,4% y a ambas técnicas del 13,8%. De los pacientes con leucemia o linfoma ventilados mecánicamente en cualquiera de sus ingresos sobrevivió a la UCI el 10,3% (93 días de estancia por cada vida salvada), pero solo el 7,7% estaba vivo a los 6 meses. Conclusiones: Dado que, en todos los grupos, la supervivencia en la UCI fue mayor del 10%, el ingreso de estos pacientes está justificado (AU)

Background and objective: The survival of haematologic patients admitted to Intensive Care units (ICU) isso poor, that it is debatable whether they should be admitted or not to them. We aimed to find out the survival of these patients in an ICU to know if their admission is justified. Patients and method: Retrospective study of 600 haematologic patients (49.4 16.4 years, 58.3% male)representing a total of 660 different admissions to the ICU of a university hospital, with a 6 months follow-up. Haematologic diseases were: leukaemia (50.5%), lymphoma (18.7%), myeloma (10.0%), myelody splasic syndromes (4.2%), aplastic anaemia or bone marrow aplasia (3.3%), thrombotic microangiopathies and HELL Psyndrome (7.4%), and others. Results: A total of 37.5% of patients survived. Survival of thrombotic microangiopathies and HELL Psyndrome was higher (81.8% of patients) than that of leukaemias (26.6%) and lymphomas (49.1%). When the reason for ICU admission was respiratory failure with or without septic shock, the survival was lower(20 and 27% of admissions respectively) than when it was septic shock alone (58.7%). Survival of mechanically ventilated patients was 14.6%, that of those treated with any renal replacement therapy32.4% and that of patients with both treatments 13.8%. From all mechanically ventilated leukaemia or lymphoma patients, 10.3% survived (93 days in the ICU per life saved) but only 7.7% were alive 6 months later. Conclusions: Considering that the ICU survival was higher than 10% for all the groups studied, we conclude that admission of haematologic patients to the ICU is appropriate (AU)

[Survival of haematologic patients admitted to an Intensive Care Unit. A 16 years study]. / Supervivencia de los pacientes con hemopatías ingresados en una Unidad de Medicina Intensiva. Estudio de 16 años.

BACKGROUND AND OBJECTIVE: The survival of haematologic patients admitted to Intensive Care units (ICU) is so poor, that it is debatable whether they should be admitted or not to them. We aimed to find out the survival of these patients in an ICU to know if their admission is justified. PATIENTS AND METHOD: Retrospective study of 600 haematologic patients (49.4 ± 16.4 years, 58.3% male) representing a total of 660 different admissions to the ICU of a university hospital, with a 6 months follow-up. Haematologic diseases were: leukaemia (50.5%), lymphoma (18.7%), myeloma (10.0%), myelodysplasic syndromes (4.2%), aplastic anaemia or bone marrow aplasia (3.3%), thrombotic microangiopathies and HELLP syndrome (7.4%), and others. RESULTS: A total of 37.5% of patients survived. Survival of thrombotic microangiopathies and HELLP syndrome was higher (81.8% of patients) than that of leukaemias (26.6%) and lymphomas (49.1%). When the reason for ICU admission was respiratory failure with or without septic shock, the survival was lower (20 and 27% of admissions respectively) than when it was septic shock alone (58.7%). Survival of mechanically ventilated patients was 14.6%, that of those treated with any renal replacement therapy 32.4% and that of patients with both treatments 13.8%. From all mechanically ventilated leukaemia or lymphoma patients, 10.3% survived (93 days in the ICU per life saved) but only 7.7% were alive 6 months later. CONCLUSIONS: Considering that the ICU survival was higher than 10% for all the groups studied, we conclude that admission of haematologic patients to the ICU is appropriate.