The outcome of patients admitted to an intensive care unit with haematological malignancy: a case–control study

Introduction

The outcome of patients with haematological malignancy admitted to the ICU has been reported as between 34% and 75%. Historically, these patients have been regarded as having a poor prognosis once admitted to the ICU. We decided to compare the ICU and hospital mortality of these patients with patients of a similar age and severity of acute illness.

Methods

Twenty-four patients were admitted to the ICU from August 2004 to August 2006 with a haematological malignancy. These were case-matched using sex, age (± 2 years), APACHE II score (± 2) and admission diagnosis with patients admitted to the ICU without a diagnosis of haematological malignancy. Eighteen patients were matched to one case control; however, in six patients, two matches were found. Where it was impossible to differentiate between cases on the grounds of diagnosis, age or APACHE II score they were both included. We compared ICU and hospital mortality between the two groups.

Results

Patients with a haematological malignancy had an ICU mortality of 50%, and a hospital mortality of 58%. Control patients had an ICU mortality of 60%, and a hospital mortality of 67% (statistically nonsignificant). The length of time to admission between the two groups was significantly longer in the haematology group at 12.4 days, compared with 2.8 days in the control patients (P < 0.05). The level of organ support was the same between the two cohorts.

Conclusion

We have demonstrated that, for our unit, there was no statistically significant difference in hospital or ICU mortality between the two groups. In fact, the group with a haematological malignancy had a lower mortality than the control group. The presence of haematological malignancy, of itself, does not appear to increase the mortality risk, when compared with a population of patients without haematological malignancy of a similar age, APACHE II score and admission diagnosis.