TY - JOUR
T1 - Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia
T2 - a Danish nationwide cohort study
AU - Maeng, Cecilie Velsoe
AU - Christiansen, Christian Fynbo
AU - Liu, Kathleen Dori
AU - Kamper, Peter
AU - Christensen, Steffen
AU - Medeiros, Bruno C.
AU - Østgård, Lene Sofie Granfeldt
PY - 2022
Y1 - 2022
N2 - Identifying risk factors for intensive care unit (ICU) admission in acute leukemia (AL) patients may guide decision-making and improve prognosis. We included all adult AL patients receiving high-intensive chemotherapy in Denmark from 2005 to 2016. We examined risk factors [crude and adjusted (a) relative risks (RRs) with 95% confidence intervals (CI)] and calculated RRs of death after 1-, 3-, and 5-years in ICU-admitted patients compared with matched cohorts. In 1417 AML and 306 ALL patients, the 1-year risk of ICU admission was 28.1% for AML and 26.4% for ALL patients, with the majority related to the first course of chemotherapy. Performance status >1 was associated with increased risk. The 1-year mortality was higher in ICU-admitted patients (AML: 69.7 vs. 35.0% [aRR 2.74;CI = 2.17–3.47]; ALL 65.0 vs. 20.0% [aRR 3.04;CI = 1.54–6.02]). The excess mortality decreased with time. In this study, performance status was associated with increased risk of ICU admission and identifies high-risk patients. ICU admission was associated with high mortality, especially within the first year.
AB - Identifying risk factors for intensive care unit (ICU) admission in acute leukemia (AL) patients may guide decision-making and improve prognosis. We included all adult AL patients receiving high-intensive chemotherapy in Denmark from 2005 to 2016. We examined risk factors [crude and adjusted (a) relative risks (RRs) with 95% confidence intervals (CI)] and calculated RRs of death after 1-, 3-, and 5-years in ICU-admitted patients compared with matched cohorts. In 1417 AML and 306 ALL patients, the 1-year risk of ICU admission was 28.1% for AML and 26.4% for ALL patients, with the majority related to the first course of chemotherapy. Performance status >1 was associated with increased risk. The 1-year mortality was higher in ICU-admitted patients (AML: 69.7 vs. 35.0% [aRR 2.74;CI = 2.17–3.47]; ALL 65.0 vs. 20.0% [aRR 3.04;CI = 1.54–6.02]). The excess mortality decreased with time. In this study, performance status was associated with increased risk of ICU admission and identifies high-risk patients. ICU admission was associated with high mortality, especially within the first year.
KW - Acute leukemia
KW - acute lymphoblastic leukemia (ALL)
KW - acute myeloid leukemia (AML)
KW - intensive care
KW - mortality
KW - risk factors
KW - Acute Disease
KW - Intensive Care Units
KW - Prognosis
KW - Hospital Mortality
KW - Humans
KW - Risk Factors
KW - Leukemia, Myeloid, Acute/diagnosis
KW - Denmark/epidemiology
KW - Adult
KW - Retrospective Studies
KW - Cohort Studies
UR - http://www.scopus.com/inward/record.url?scp=85130588332&partnerID=8YFLogxK
U2 - 10.1080/10428194.2022.2074984
DO - 10.1080/10428194.2022.2074984
M3 - Journal article
C2 - 35583300
AN - SCOPUS:85130588332
SN - 1042-8194
VL - 63
SP - 2290
EP - 2300
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 10
ER -