Author/Authors :
Kraguljac, Alan P. Department of Medicine & Interdepartmental Division of Critical Care - Mount Sinai Hospital, Toronto, Canada , Croucher, Danielle Department of Medicine & Interdepartmental Division of Critical Care - Mount Sinai Hospital, Toronto, Canada , Christian, Michael Department of Medicine & Interdepartmental Division of Critical Care - Mount Sinai Hospital, Toronto, Canada , Ibrahimova, Narmin Division of Medical Oncology & Haematology - Princess Margaret Cancer Centre, Toronto, Canada , Kumar, Vikram Department of Medicine & Interdepartmental Division of Critical Care - Mount Sinai Hospital, Toronto, Canada , Jacob, Gabriella Department of Medicine & Interdepartmental Division of Critical Care - Mount Sinai Hospital, Toronto, Canada , Kiss, Alex Department of Research Design and Biostatistics - Sunnybrook Health Sciences Centre, Toronto, Canada , Minden, Mark D. Faculty of Medicine - University of Toronto, Toronto, Canada , Mehta, Sangeeta Department of Medicine & Interdepartmental Division of Critical Care - Mount Sinai Hospital, Toronto, Canada
Abstract :
Purpose. The objectives were to describe the management and outcomes of acute leukemia (AL) patients admitted to the ICU and to
identify predictors of ICU mortality. Methods. Data was retrospectively collected from the medical records of all patients with AML
or ALL admitted to the Mount Sinai Hospital ICU from August 2009 to December 2012. Results. 151 AL patients (117 AML, 34 ALL)
were admitted to the ICU. Mean age was 54 (SD 15) years, median APACHE II score was 27 (IQR 22–33), and 50% were female.
While in ICU, 128 (85%) patients had sepsis and 56 (37%) had ARDS. The majority of patients required invasive organ support: 94
(62%) required mechanical ventilation while 23 (15%) received renal replacement therapy. Multivariable analysis identified SOFA
score (OR 1.18, 95% CI 1.01–1.38) and invasive ventilation (OR 9.64, 95% CI 3.39–27.4) as independent predictors of ICU mortality.
Ninety-four (62%) patients survived to ICU discharge. Only 39% of these 94 patients discharged were alive 12 months after ICU
admission. Conclusions. AL patients admitted to the ICU had a 62% ICU survival rate; yet only 25% of cohort patients were alive 12
months after ICU admission. Higher admission SOFA scores and invasive ventilation are independently associated with a greater
risk of dying in the ICU.
