Outcome of Hematopoietic Stem Cell Transplant Recipients Admitted to the Intensive Care Unit

Stem cell transplantation (SCT) is associated with complications that may necessitate intensive care unit (ICU) admission. The outcome for SCT patients requiring ICU admission has been reported to be poor. We describe the outcome of consecutive SCT patients admitted to the ICU at a single center. Th...

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Vydané v:Biology of blood and marrow transplantation Ročník 12; číslo 3; s. 301 - 305
Hlavní autori: Kew, Andrea K., Couban, Stephen, Patrick, Ward, Thompson, Kara, White, Darrell
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.03.2006
Predmet:
Adolescent
Adult
Aged
Allogeneic
Autologous
Female
Hematopoietic Stem Cell Transplantation - mortality
Humans
Intensive care
Intensive Care Units
Male
Middle Aged
Neoplasms - complications
Neoplasms - mortality
Neoplasms - therapy
Prognosis
Respiratory Insufficiency - complications
Respiratory Insufficiency - mortality
Respiratory Insufficiency - therapy
Retrospective Studies
Stem cell transplant
Survival Rate
Transplantation, Homologous
Treatment Outcome
Vasoconstrictor Agents - adverse effects
Vasoconstrictor Agents - therapeutic use
Allogeneic
Autologous
Intensive care
Prognosis
Stem cell transplant
ISSN:1083-8791, 1523-6536
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Shrnutí:Stem cell transplantation (SCT) is associated with complications that may necessitate intensive care unit (ICU) admission. The outcome for SCT patients requiring ICU admission has been reported to be poor. We describe the outcome of consecutive SCT patients admitted to the ICU at a single center. The study was a retrospective review of all patients at the Queen Elizabeth II Health Sciences Center who received an SCT between 1992 and 2001 and were subsequently admitted to the ICU. The primary outcome was overall survival at 12 months after ICU admission. There were 440 SCTs in the study period; 38 of these patients were admitted to the ICU on 42 separate occasions. The primary indication for ICU admission was respiratory failure. The probability of survival at 12 months was 21.6% (95% CI, 8.4%-34.9%). On multivariate analysis, the only statistically significant variable associated with decreased 12-month survival was vasopressor use. The probability of survival for patients receiving vasopressor support was 5% (95% CI, 0%-14.5%) at 30 days and 0% at 12 months, whereas the probability of survival for patients not receiving vasopressor support was 76.5% (95% CI, 56.3%-96.6%) at 30 days and 45.8% (95% CI, 21.5%-69.9%) at 12 months. In this 10-year review of consecutive SCT recipients requiring ICU admission, we found that the outcome of SCT patients requiring ICU admission may not be as poor as previously reported. However, SCT recipients requiring vasopressor support had very poor outcomes. These findings will be important in deciding which SCT patients may benefit from ICU admission and care.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1083-8791
1523-6536
DOI:10.1016/j.bbmt.2005.10.020