Hemodynamics, fluids & transfusion
Severe bleeding events among critically ill patients with haematological malignancies
Authors' conclusion
Major bleeding events are common complications in critically ill patients with haematological malignancies and are associated with a worsened prognosis.
Study context
- Population
- Adults with a history of haematological malignancy requiring unplanned ICU admission, 2007–2018analysed
- Participants
- 1,012 adults
- Exposure
- Bleeding vs Non-bleeding
- Bleedingn = 109
- Outcome
- ICU-acquired (after the first 24 h in the ICU) severe bleeding events (WHO grades 3 or 4)
Methodological detailssingle-center
- Single-center
Main finding
As reported in the abstract
ICU-acquired severe bleeding events (WHO grade 3 or 4)
Patients with ICU-acquired severe bleeding events
109
10.8%
Time in ICU to bleeding event
3.0 days
1.0–7.0
Main source of bleeding: gastrointestinal tract
n = 44, 40.3%
Observational data: associations, not effects.
Further findings
In-ICU mortality
P < 0.001
In-hospital mortality
P < 0.001
Independent predictors of ICU-acquired severe bleeding (multivariate) · day prior to the event
| CSH (CI) | P value | |
|---|---|---|
| Primary bleeding event at ICU admission | 4.17 (2.71–6.43) | P < 0.001 |
| Non-platelet SOFA scorePer point increase | 1.06 (1.01–1.11) | P = 0.02 |
| Prolonged prothrombin timePer 5-percent increase | 0.90 (0.85–0.96) | P = 0.001 |
| Outcome | Bleeding | Non-bleeding | Cause-specific hazard (CI) | P value |
|---|---|---|---|---|
| ICU LOS | 9.0 (range 1.0–6.0) days | 3.0 (range 3.5–15.0) | P < 0.001 | |
| Independent predictors of ICU-acquired severe bleeding (multivariate) · day prior to the eventCKD | 2.00 (1.19–3.31) | P = 0.008 |
- Main source of bleeding: gastrointestinal tract
- 40.3% · 44 of 109
Original publication
Severe bleeding events among critically ill patients with haematological malignancies. Ann Intensive Care. Published 7 October 2024. doi:10.
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