The factors affecting survival in patients followed up with the diagnosis of lymphoma in the intensive care unit

Kaniye Aydın; Ömer Doğan

Makale detayları

The factors affecting survival in patients followed up with the diagnosis of lymphoma in the intensive care unit

Yazarlar:

Kaniye Aydın | Ömer Doğan

Yayıncı:

Cukurova University

Ana Başlıklar:

Yoğun Bakım

Dergi:

Cukurova Medical Journal Vol.48 Issue 3, pp.1007-1015

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286411

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: This retrospective analysis aimed to elucidate the key factors influencing survival outcomes in patients diagnosed with lymphoma and admitted to an Intensive Care Unit ICU. Materials and Methods: The study cohort comprised individuals aged 18 or older diagnosed with lymphoma and admitted to the ICU between November 2015 and February 2023. Data were collected on patients demographic characteristics, primary hematological diagnoses, reasons for ICU admission, laboratory parameters, Acute Physiology and Chronic Health Evaluation APACHE II scores, Sequential Organ Failure Assessment SOFA scores, clinical trajectory, and 28-day mortality rates. Patients were stratified into two categories based on their mortality outcomes: Survivors and non-survivors. Results: A total of 165 patients were included in the study, with a mean age of 52.41  17.99 years; 63 were male. Table 1 summarizes the demographic characteristics, clinical trajectories, and 28-day mortality rates. The APACHE II and SOFA scores of the patients were 34 753 and 12 1014, respectively. The predominant reasons for ICU admission were sepsis 58.2 and acute respiratory failure 57.6. Vasopressor necessity prior to and during ICU stay was 23.6 and 92.4, respectively. During ICU monitoring, thrombocytopenia, and acute kidney injury AKI were observed in 77.6 and 66.4 of patients, respectively; 10 required renal replacement therapy. The 28-day mortality rate was 84.8. Kaplan-Meier analysis revealed that patients with a SOFA score  9 had a significantly reduced survival time of 4.5  0.4 days compared to those with lower SOFA scores 14.3  2.6 days. Patients with AKI and those requiring invasive mechanical ventilation IMV exhibited reduced survival times of 4.7  0.5 days and 5.6  0.5 days, respectively. Elevated SOFA scores HR 2.355, 95 CI 1.4853.734, presence of AKI HR 1.511, 95 CI 1.0552.163, and the need for IMV HR 5.721, 95 CI 1.37723.770 were significantly correlated with increased 28-day mortality. Receiver Operating Characteristic ROC curve analysis identified the optimal SOFA cut-off point for predicting 28-day mortality as nine, with an Area Under the Curve AUC of 0.897, sensitivity 83.6 and specificity 92. Conclusions: The findings of this study underscore the elevated mortality rates among lymphoma patients admitted to the ICU. Our data suggest that several factors serve as significant predictors of 28-day mortality in this patient population. Specifically, elevated APACHE II scores, SOFA scores, the presence of AKI, and the requirement for IMV emerged as crucial indicators associated with adverse survival outcomes. Consequently, these factors warrant meticulous monitoring and could inform targeted interventions to improve survival rates among lymphoma patients in critical care settings.

 Purpose: This retrospective analysis aimed to elucidate the key factors influencing survival outcomes in patients diagnosed with lymphoma and admitted to an Intensive Care Unit ICU. Materials and Methods: The study cohort comprised individuals aged 18 or older diagnosed with lymphoma and admitted to the ICU between November 2015 and February 2023. Data were collected on patients demographic characteristics, primary hematological diagnoses, reasons for ICU admission, laboratory parameters, Acute Physiology and Chronic Health Evaluation APACHE II scores, Sequential Organ Failure Assessment SOFA scores, clinical trajectory, and 28-day mortality rates. Patients were stratified into two categories based on their mortality outcomes: Survivors and non-survivors. Results: A total of 165 patients were included in the study, with a mean age of 52.41  17.99 years; 63 were male. Table 1 summarizes the demographic characteristics, clinical trajectories, and 28-day mortality rates. The APACHE II and SOFA scores of the patients were 34 753 and 12 1014, respectively. The predominant reasons for ICU admission were sepsis 58.2 and acute respiratory failure 57.6. Vasopressor necessity prior to and during ICU stay was 23.6 and 92.4, respectively. During ICU monitoring, thrombocytopenia, and acute kidney injury AKI were observed in 77.6 and 66.4 of patients, respectively; 10 required renal replacement therapy. The 28-day mortality rate was 84.8. Kaplan-Meier analysis revealed that patients with a SOFA score  9 had a significantly reduced survival time of 4.5  0.4 days compared to those with lower SOFA scores 14.3  2.6 days. Patients with AKI and those requiring invasive mechanical ventilation IMV exhibited reduced survival times of 4.7  0.5 days and 5.6  0.5 days, respectively. Elevated SOFA scores HR 2.355, 95 CI 1.4853.734, presence of AKI HR 1.511, 95 CI 1.0552.163, and the need for IMV HR 5.721, 95 CI 1.37723.770 were significantly correlated with increased 28-day mortality. Receiver Operating Characteristic ROC curve analysis identified the optimal SOFA cut-off point for predicting 28-day mortality as nine, with an Area Under the Curve AUC of 0.897, sensitivity 83.6 and specificity 92. Conclusions: The findings of this study underscore the elevated mortality rates among lymphoma patients admitted to the ICU. Our data suggest that several factors serve as significant predictors of 28-day mortality in this patient population. Specifically, elevated APACHE II scores, SOFA scores, the presence of AKI, and the requirement for IMV emerged as crucial indicators associated with adverse survival outcomes. Consequently, these factors warrant meticulous monitoring and could inform targeted interventions to improve survival rates among lymphoma patients in critical care settings.

 Purpose: This retrospective analysis aimed to elucidate the key factors influencing survival outcomes in patients diagnosed with lymphoma and admitted to an Intensive Care Unit ICU. Materials and Methods: The study cohort comprised individuals aged 18 or older diagnosed with lymphoma and admitted to the ICU between November 2015 and February 2023. Data were collected on patients demographic characteristics, primary hematological diagnoses, reasons for ICU admission, laboratory parameters, Acute Physiology and Chronic Health Evaluation APACHE II scores, Sequential Organ Failure Assessment SOFA scores, clinical trajectory, and 28-day mortality rates. Patients were stratified into two categories based on their mortality outcomes: Survivors and non-survivors. Results: A total of 165 patients were included in the study, with a mean age of 52.41  17.99 years; 63 were male. Table 1 summarizes the demographic characteristics, clinical trajectories, and 28-day mortality rates. The APACHE II and SOFA scores of the patients were 34 753 and 12 1014, respectively. The predominant reasons for ICU admission were sepsis 58.2 and acute respiratory failure 57.6. Vasopressor necessity prior to and during ICU stay was 23.6 and 92.4, respectively. During ICU monitoring, thrombocytopenia, and acute kidney injury AKI were observed in 77.6 and 66.4 of patients, respectively; 10 required renal replacement therapy. The 28-day mortality rate was 84.8. Kaplan-Meier analysis revealed that patients with a SOFA score  9 had a significantly reduced survival time of 4.5  0.4 days compared to those with lower SOFA scores 14.3  2.6 days. Patients with AKI and those requiring invasive mechanical ventilation IMV exhibited reduced survival times of 4.7  0.5 days and 5.6  0.5 days, respectively. Elevated SOFA scores HR 2.355, 95 CI 1.4853.734, presence of AKI HR 1.511, 95 CI 1.0552.163, and the need for IMV HR 5.721, 95 CI 1.37723.770 were significantly correlated with increased 28-day mortality. Receiver Operating Characteristic ROC curve analysis identified the optimal SOFA cut-off point for predicting 28-day mortality as nine, with an Area Under the Curve AUC of 0.897, sensitivity 83.6 and specificity 92. Conclusions: The findings of this study underscore the elevated mortality rates among lymphoma patients admitted to the ICU. Our data suggest that several factors serve as significant predictors of 28-day mortality in this patient population. Specifically, elevated APACHE II scores, SOFA scores, the presence of AKI, and the requirement for IMV emerged as crucial indicators associated with adverse survival outcomes. Consequently, these factors warrant meticulous monitoring and could inform targeted interventions to improve survival rates among lymphoma patients in critical care settings.

 Amaç: Bu retrospektif analiz, lenfoma tanısı konan ve Yoğun Bakım Ünitesine YBÜ yatırılan hastalarda sağkalım sonuçlarını etkileyen temel faktörleri aydınlatmayı amaçlamıştır. Gereç ve Yöntem: Çalışma grubu, Kasım 2015 ile Şubat 2023 arasında lenfoma tanısı konan ve YBÜye kabul edilen 18 yaş ve üzeri bireylerden oluşmaktadır. Hastaların demografik özellikleri, birincil hematolojik tanıları, YBÜye kabul nedenleri, laboratuvar parametreleri, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi APACHE II skorları, Sıralı Organ Yetmezliği Değerlendirmesi SOFA skorları, klinik seyirleri ve 28 günlük mortalite oranları hakkında veriler toplanmıştır. Hastalar mortalite sonuçlarına göre iki kategoriye ayrılmıştır: Hayatta kalanlar ve ölenler. Bulgular: Ortalama yaşı 52,41  17,99 yıl olan toplam 165 hasta çalışmaya dahil edilmiştir; hastaların 63ü erkektir. Tablo 1 demografik özellikleri, klinik seyirleri ve 28 günlük mortalite oranlarını özetlemektedir. Hastaların APACHE II ve SOFA skorları sırasıyla 34 7-53 ve 12 10-14idi. YBÜye kabulün başlıca nedenleri sepsis 58,2 ve akut solunum yetmezliğiydi 57,6. YBÜde kalış öncesinde ve sırasında vazopressör ihtiyacı sırasıyla 23,6 ve 92,4 idi. YBÜ izlemi sırasında hastaların sırasıyla 77,6 ve 66,4ünde trombositopeni ve akut böbrek hasarı ABH gözlendi; 10unda renal replasman tedavisi gerekti. 28 günlük mortalite oranı 84,8 idi. Kaplan-Meier analizi, SOFA skoru  9 olan hastaların sağkalım süresinin SOFA skoru daha düşük olanlara kıyasla 14,3  2,6 gün 4,5  0,4 gün daha kısa olduğunu ortaya koymuştur. Akut böbrek hasarı olan ve invaziv mekanik ventilasyon IMV gerektiren hastalarda sırasıyla 4,7  0,5 gün ve 5,6  0,5 günlük azalmış sağkalım süreleri görülmüştür. Yüksek SOFA skorları HR 2.355, 95 CI 1.485-3.734, AKI varlığı HR 1.511, 95 CI 1.055-2.163 ve IMV ihtiyacı HR 5.721, 95 CI 1.377-23.770 artmış 28 günlük mortalite ile anlamlı şekilde ilişkiliydi. Alıcı İşlem Karakteristiği ROC eğrisi analizi, 28 günlük ölüm oranını tahmin etmede optimal SOFA kesme noktasını dokuz olarak tanımladı; Eğri Altındaki Alan AUC 0,897, duyarlılık 83,6 ve özgüllük 92idi. Sonuç: Bu çalışmanın bulguları, YBÜye kabul edilen lenfoma hastaları arasındaki yüksek mortalite oranlarının altını çizmektedir. Verilerimiz, bu hasta popülasyonunda çeşitli faktörlerin 28 günlük mortalitenin önemli belirleyicileri olduğunu göstermektedir. Özellikle, yüksek APACHE II skorları, SOFA skorları, AKI varlığı ve IMV gereksinimi, olumsuz sağkalım sonuçlarıyla ilişkili önemli göstergeler olarak ortaya çıkmıştır. Sonuç olarak, bu faktörler titiz bir izlem gerektirmektedir ve kritik bakım ortamlarındaki lenfoma hastalarındaki sağkalım oranlarını iyileştirmek için hedeflenen müdahaleler hakkında bilgi verebilir.

Makale detayları

The factors affecting survival in patients followed up with the diagnosis of lymphoma in the intensive care unit

Yazarlar:

Kaniye Aydın | Ömer Doğan

Yayıncı:

Cukurova University

Ana Başlıklar:

Yoğun Bakım

Dergi:

Cukurova Medical Journal Vol.48 Issue 3, pp.1007-1015

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286411

pISSN:

2602-3032

Lymphoma

Mortality

Intensive care unit

apache ıı score

SOFA score

Lenfoma

Yoğun Bakım Ünitesi

APACHE II skoru

SOFA skoru

Mortalite

Sayı

Makale detayları

Yazarlar: Kaniye Aydın | Ömer Doğan

Yayıncı: Cukurova University

Ana Başlıklar: Yoğun Bakım

Dergi: Cukurova Medical Journal Vol.48 Issue 3, pp.1007-1015

Belge Tipi: Makale

Yayın Tarihi: 9/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001286411

pISSN: 2602-3032

Sayı

Yazarlar:

Kaniye Aydın | Ömer Doğan

Yayıncı:

Cukurova University

Ana Başlıklar:

Yoğun Bakım

Dergi:

Cukurova Medical Journal Vol.48 Issue 3, pp.1007-1015

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286411

pISSN:

2602-3032