ICU sedation, delirium & recovery
Impact of critical illness on continuation of anticancer treatment and prognosis of patients with aggressive hematological malignancies
Authors' conclusion
The intended cancer treatment could be resumed in 58% of ICU survivors with aggressive hematological malignancies. At the time of ICU discharge, advanced age, persistent liver dysfunction and decisions to limit further life-support therapies were independent determinants of cancer treatment modifications. These modifications were associated with worsened one-year outcomes.
Study context
- Population
- Intensive care unit (ICU) survivors with acute myeloid leukemia (AML) or aggressive B-NHL discharged alive after an unplanned admission, 2013–2021366 admitted to ICU
- Participants
- 170 survivors
- Exposure
- AML vs B-NHL
- AMLn = 92
- B-NHLn = 78
- Outcome
- Change in the intended optimal cancer treatment following ICU discharge
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Further modifications in hematologic treatment regimens required (n = 72)
42%
Age > 65 years associated with modifications (multivariate)
OR 3.54
95%-CI 1.67–7.50p < 0.001
ICU-discharge hyperbilirubinemia > 20 µmol/L associated with modifications (multivariate)
OR 3.01
1.10–8.15p = 0.031
Therapeutic limitations associated with modifications (multivariate)
OR 16.5
1.83–149.7p = 0.012
Observational data: associations, not effects.
Secondary outcomes
1-year survival after ICU discharge
- One-year survival rate following ICU discharge
- 59.5%
Impact of post-ICU cancer treatment modifications on survival
- Significant impact on in-hospital, 1-year OS and progression-free survival
Original publication
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