Respiratory failure & ventilation
Characteristics and outcomes of patients with acute myeloid leukemia admitted to intensive care unit with acute respiratory failure: a post-hoc analysis of a prospective multicenter study
Authors' conclusion
Among AML patients with ARF, factors associated with a worse outcome are related to patient's background (performance status, leukemic pulmonary involvement), symptoms, radiological findings, the need for vasopressors and the liver SOFA score.
Study context
- Population
- Patients with Acute Myeloid Leukemia (AML) and acute respiratory failure admitted to intensive care unit (ICU)of 1611 immunocompromised patients
- Participants
- 201 patients
- Primary endpoint
- Hospital mortality and associated risk factors
Methodological detailspost-hoc analysis, cluster analysis
- Post-hoc analysis
- Cluster analysis
Primary result
As reported in the abstract
Hospital mortality
- Hospital mortality
- 46.8%
- ECOG performance status ≥ 2 associated with mortality, OR
- 2.79 (p = 0.04)
- Cough associated with mortality, OR
- 2.94 (p = 0.034)
- Use of vasopressors associated with mortality, OR
- 2.79 (p = 0.044)
- Leukemia-specific pulmonary involvement (leukostasis, pulmonary infiltration by blasts or acute lysis pneumopathy) associated with mortality, OR
- 4.76 (p = 0.011)
- Liver SOFA score associated with mortality, OR
- 1.85 (p = 0.014)
- Focal alveolar chest X-ray pattern associated with survival, OR
- 0.13 (p = 0.001)
Further findings
- 3 clusters identified: leukemic (high-risk AML, isolated milder acute respiratory failure (ARF)), pulmonary (symptomatic, highly oxygen-requiring severe ARF with diffuse radiological findings, heavily immunocompromised), inflammatory (multi-organ failures in addition to ARF)
- Clusters 2 and 3 independently associated with hospital mortality in multivariate analysis
Original publication
Characteristics and outcomes of patients with acute myeloid leukemia admitted to intensive care unit with acute respiratory failure: a post-hoc analysis of a prospective multicenter study. Ann Intensive Care. Published 2 September 2023. doi:10.
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