Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit

M. A. Trinkaus, S. E. Lapinsky, M. Crump, A. Keating, D. E. Reece, C. Chen, D. C. Hallett, N. Franke, A. Winter, Joseph R Mikhael

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Between January 2001 and July 2006, 1013 patients received autologous hematopoietic cell transplants (AHCT) at Canada's largest transplant center. In this retrospective cohort study of AHCT patients admitted to the intensive care unit (ICU), we describe the outcomes following ICU admission and the variables measured in the first 24 h of ICU admission associated with overall ICU mortality. Results indicate a 3.3% ICU admission rate (n = 34) with 13 deaths (1% overall mortality rate, 38% in ICU mortality rate). The worst outcome was in AL amyloid patients of whom 28% were admitted to the ICU, with an ICU mortality rate of 55%. The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score in the first 24 h were statistically associated with mortality by univariate analysis. Other variables measured at 24 h and associated with ICU mortality included multiorgan failure, mechanical ventilation, inotropic support >4 h and Gram-negative sepsis. Our data indicate that ICU admission in the autotransplant population is rare and that it is influenced by underlying diagnosis, with AL amyloid patients having the highest risk. Our observations may assist clinical decision-making regarding the continuation of intensive care delivered 24 h after ICU admission.

Original languageEnglish (US)
Pages (from-to)411-415
Number of pages5
JournalBone Marrow Transplantation
Volume43
Issue number5
DOIs
StatePublished - 2009

Fingerprint

Cell Transplantation
Intensive Care Units
Mortality
APACHE
Transplants
Amyloid
Organ Dysfunction Scores
Autografts
Critical Care
Artificial Respiration
Canada
Sepsis
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Trinkaus, M. A., Lapinsky, S. E., Crump, M., Keating, A., Reece, D. E., Chen, C., ... Mikhael, J. R. (2009). Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit. Bone Marrow Transplantation, 43(5), 411-415. https://doi.org/10.1038/bmt.2008.336

Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit. / Trinkaus, M. A.; Lapinsky, S. E.; Crump, M.; Keating, A.; Reece, D. E.; Chen, C.; Hallett, D. C.; Franke, N.; Winter, A.; Mikhael, Joseph R.

In: Bone Marrow Transplantation, Vol. 43, No. 5, 2009, p. 411-415.

Research output: Contribution to journalArticle

Trinkaus, MA, Lapinsky, SE, Crump, M, Keating, A, Reece, DE, Chen, C, Hallett, DC, Franke, N, Winter, A & Mikhael, JR 2009, 'Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit', Bone Marrow Transplantation, vol. 43, no. 5, pp. 411-415. https://doi.org/10.1038/bmt.2008.336
Trinkaus, M. A. ; Lapinsky, S. E. ; Crump, M. ; Keating, A. ; Reece, D. E. ; Chen, C. ; Hallett, D. C. ; Franke, N. ; Winter, A. ; Mikhael, Joseph R. / Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit. In: Bone Marrow Transplantation. 2009 ; Vol. 43, No. 5. pp. 411-415.
@article{b6421b6cb6814286998be5e9aa30c323,
title = "Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit",
abstract = "Between January 2001 and July 2006, 1013 patients received autologous hematopoietic cell transplants (AHCT) at Canada's largest transplant center. In this retrospective cohort study of AHCT patients admitted to the intensive care unit (ICU), we describe the outcomes following ICU admission and the variables measured in the first 24 h of ICU admission associated with overall ICU mortality. Results indicate a 3.3{\%} ICU admission rate (n = 34) with 13 deaths (1{\%} overall mortality rate, 38{\%} in ICU mortality rate). The worst outcome was in AL amyloid patients of whom 28{\%} were admitted to the ICU, with an ICU mortality rate of 55{\%}. The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score in the first 24 h were statistically associated with mortality by univariate analysis. Other variables measured at 24 h and associated with ICU mortality included multiorgan failure, mechanical ventilation, inotropic support >4 h and Gram-negative sepsis. Our data indicate that ICU admission in the autotransplant population is rare and that it is influenced by underlying diagnosis, with AL amyloid patients having the highest risk. Our observations may assist clinical decision-making regarding the continuation of intensive care delivered 24 h after ICU admission.",
author = "Trinkaus, {M. A.} and Lapinsky, {S. E.} and M. Crump and A. Keating and Reece, {D. E.} and C. Chen and Hallett, {D. C.} and N. Franke and A. Winter and Mikhael, {Joseph R}",
year = "2009",
doi = "10.1038/bmt.2008.336",
language = "English (US)",
volume = "43",
pages = "411--415",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "5",

}

TY - JOUR

T1 - Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit

AU - Trinkaus, M. A.

AU - Lapinsky, S. E.

AU - Crump, M.

AU - Keating, A.

AU - Reece, D. E.

AU - Chen, C.

AU - Hallett, D. C.

AU - Franke, N.

AU - Winter, A.

AU - Mikhael, Joseph R

PY - 2009

Y1 - 2009

N2 - Between January 2001 and July 2006, 1013 patients received autologous hematopoietic cell transplants (AHCT) at Canada's largest transplant center. In this retrospective cohort study of AHCT patients admitted to the intensive care unit (ICU), we describe the outcomes following ICU admission and the variables measured in the first 24 h of ICU admission associated with overall ICU mortality. Results indicate a 3.3% ICU admission rate (n = 34) with 13 deaths (1% overall mortality rate, 38% in ICU mortality rate). The worst outcome was in AL amyloid patients of whom 28% were admitted to the ICU, with an ICU mortality rate of 55%. The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score in the first 24 h were statistically associated with mortality by univariate analysis. Other variables measured at 24 h and associated with ICU mortality included multiorgan failure, mechanical ventilation, inotropic support >4 h and Gram-negative sepsis. Our data indicate that ICU admission in the autotransplant population is rare and that it is influenced by underlying diagnosis, with AL amyloid patients having the highest risk. Our observations may assist clinical decision-making regarding the continuation of intensive care delivered 24 h after ICU admission.

AB - Between January 2001 and July 2006, 1013 patients received autologous hematopoietic cell transplants (AHCT) at Canada's largest transplant center. In this retrospective cohort study of AHCT patients admitted to the intensive care unit (ICU), we describe the outcomes following ICU admission and the variables measured in the first 24 h of ICU admission associated with overall ICU mortality. Results indicate a 3.3% ICU admission rate (n = 34) with 13 deaths (1% overall mortality rate, 38% in ICU mortality rate). The worst outcome was in AL amyloid patients of whom 28% were admitted to the ICU, with an ICU mortality rate of 55%. The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score in the first 24 h were statistically associated with mortality by univariate analysis. Other variables measured at 24 h and associated with ICU mortality included multiorgan failure, mechanical ventilation, inotropic support >4 h and Gram-negative sepsis. Our data indicate that ICU admission in the autotransplant population is rare and that it is influenced by underlying diagnosis, with AL amyloid patients having the highest risk. Our observations may assist clinical decision-making regarding the continuation of intensive care delivered 24 h after ICU admission.

UR - http://www.scopus.com/inward/record.url?scp=62549135664&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62549135664&partnerID=8YFLogxK

U2 - 10.1038/bmt.2008.336

DO - 10.1038/bmt.2008.336

M3 - Article

C2 - 18936734

AN - SCOPUS:62549135664

VL - 43

SP - 411

EP - 415

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 5

ER -