Factors affecting mortality in patients with hematological malignancies hospitalized in the İntensive Care Unit

Intensive care unit patients with hematological malignancies have a higher mortality than other patients because this group often have acute respiratory distress, acute kidney (AKI) and liver injury (ALI) which reasons require these patients to be hospitalized in the intensive care unit (ICU). We aimed to evaluate the factors affecting mortality in patients with hematological malignancies hospitalized in the ICU. Patients and methods Patients diagnosed with hematological malignancy and admitted to the intensive care unit between 2017 and 2022 were retrospectively analyzed. 363 patient records in the hospital database were analyzed. Data of the first 75 enrollable patients were recorded as preliminary results. Patients' kidney and liver function tests, vasopressor requirement, mechanical ventilation (MV) days, ICU stay, complications and mortality were recorded. Results The mean age of patients included in the study was 61 (47–73). 68% of the patients were male. All-cause mortality was 58.7% in patients. The relationship between the laboratory parameters of the patients and mortality is given in Table 2. Vasopressor use was required in 89.3% of patients and there was a statistically significant difference between patients' use of vasopressors and mortality (p = 0.007). The need for intubation developed in 60% of the patients. The most common reason for needing intubation was acute respiratory failure (45.3%). This was followed by regression of Glasgow Coma Score (GCS), cardiac and respiratory arrest (18.7%, 14.7%, 4.0%). Mortality was higher in intubated patients and it was found to be statistically significant (p = 0.002). AKI was detected in 60% of the patients and renal replacement therapy (RRT) was used in 58.7% of them (Table 2), and no statistically significant difference was found between the need for RRT and mortality (p = 0.346) (Table 3). Ventilator-associated pneumonia developed in 21.3% of the patients. The number of days on mechanical ventilation in patients was median IQR 3 (1–8), and a statistically significant correlation was found between mortality and the number of days on mechanical ventilation (p = 0.017). The median number of ICU stay days was 5 (2–10) and the number of hospitalization days was 21 (8–32), and there was no significant difference between mortality and ICU and hospitalization days (p = 0.151 & p = 0.598). Conclusion In this study, our mortality rate was high in patients hospitalized in the ICU with hematological malignancies. Especially the development of intubation, the number of days on mechanical ventilator and the use of vasopressors were predictors of mortality. Large patient series and multicenter studies are needed to reveal more definitive results.