Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study

Cecilie Velsoe Maeng; Christian Fynbo Christiansen; Kathleen Dori Liu; Peter Kamper; Steffen Christensen; Bruno C. Medeiros; Lene Sofie Granfeldt Østgård

doi:10.1080/10428194.2022.2074984

Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study

Cecilie Velsoe Maeng^*, Christian Fynbo Christiansen, Kathleen Dori Liu, Peter Kamper, Steffen Christensen, Bruno C. Medeiros, Lene Sofie Granfeldt Østgård

^*Corresponding author for this work

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Abstract

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.

Original language	English
Journal	Leukemia & Lymphoma
Volume	63
Issue	10
Pages (from-to)	2290-2300
Number of pages	11
ISSN	1042-8194
DOIs	https://doi.org/10.1080/10428194.2022.2074984
Publication status	Published - 2022

Keywords

Acute leukemia
acute lymphoblastic leukemia (ALL)
acute myeloid leukemia (AML)
intensive care
mortality
risk factors
Acute Disease
Intensive Care Units
Prognosis
Hospital Mortality
Humans
Risk Factors
Leukemia, Myeloid, Acute/diagnosis
Denmark/epidemiology
Adult
Retrospective Studies
Cohort Studies

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Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia a Danish nationwide cohort studyFinal published version, 2.06 MBLicence: CC BY-NC-ND

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@article{aa6a1060e7974b37bcc4b7d89aad7c2c,

title = "Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study",

abstract = "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.",

keywords = "Acute leukemia, acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), intensive care, mortality, risk factors, Acute Disease, Intensive Care Units, Prognosis, Hospital Mortality, Humans, Risk Factors, Leukemia, Myeloid, Acute/diagnosis, Denmark/epidemiology, Adult, Retrospective Studies, Cohort Studies",

author = "Maeng, \{Cecilie Velsoe\} and Christiansen, \{Christian Fynbo\} and Liu, \{Kathleen Dori\} and Peter Kamper and Steffen Christensen and Medeiros, \{Bruno C.\} and {\O}stg{\aa}rd, \{Lene Sofie Granfeldt\}",

year = "2022",

doi = "10.1080/10428194.2022.2074984",

language = "English",

volume = "63",

pages = "2290--2300",

journal = "Leukemia \& Lymphoma",

issn = "1042-8194",

publisher = "Informa Healthcare",

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Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study. / Maeng, Cecilie Velsoe; Christiansen, Christian Fynbo; Liu, Kathleen Dori et al.
In: Leukemia & Lymphoma, Vol. 63, No. 10, 2022, p. 2290-2300.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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

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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 & Lymphoma

JF - Leukemia & Lymphoma

IS - 10

ER -

Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study

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