Prognosis of neutropenic patients admitted to the intensive care unit View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-01-13

AUTHORS

D. Mokart, M. Darmon, M. Resche-Rigon, V. Lemiale, F. Pène, J. Mayaux, A. Rabbat, A. Kouatchet, F. Vincent, M. Nyunga, F. Bruneel, C. Lebert, P. Perez, A. Renault, R. Hamidfar, M. Jourdain, A.-P. Meert, D. Benoit, S. Chevret, E. Azoulay

ABSTRACT

PurposeThe prognosis of critically ill cancer patients has improved recently. Controversies remain as regard to the specific prognosis impact of neutropenia in critically ill cancer patients. The primary objective of this study was to assess hospital outcome of critically ill neutropenic cancer patients admitted into the ICU. The secondary objective was to assess risk factors for unfavorable outcome in this population of patients and specific impact of neutropenia.MethodsWe performed a post hoc analysis of a prospectively collected database. The study was carried out in 17 university or university-affiliated centers in France and Belgium. Neutropenia was defined as a neutrophil count lower than 500/mm3.ResultsAmong the 1,011 patients admitted into the ICU during the study period 289 were neutropenic at the time of admission. Overall, 131 patients died during their hospital stay (hospital mortality 45.3 %). Four variables were associated with a poor outcome, namely allogeneic transplantation (OR 3.83; 95 % CI 1.75–8.35), need for mechanical ventilation (MV) (OR 6.57; 95 % CI 3.51–12.32), microbiological documentation (OR 2.33; CI 1.27–4.26), and need for renal replacement therapy (OR 2.77; 95 % CI 1.34–5.74). Two variables were associated with hospital survival, namely age younger than 70 (OR 0.22; 95 % CI 0.1–0.52) and neutropenic enterocolitis (OR 0.37; 95 % CI 0.15–0.9). A case–control analysis was also performed with patients of the initial database; after adjustment, neutropenia was not associated with hospital mortality (OR 1.27; 95 % CI 0.86–1.89).ConclusionHospital survival was closely associated with younger age and neutropenic enterocolitis. Conversely, need for conventional MV, for renal replacement therapy, and allogeneic hematopoietic stem cell transplantation (HSCT) were associated with poor outcome. More... »

PAGES

296-303

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-014-3615-y

DOI

http://dx.doi.org/10.1007/s00134-014-3615-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1017565924

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25578678


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392 grid-institutes:grid.411784.f schema:alternateName Cochin Hospital, Paris, France
393 schema:name Cochin Hospital, Paris, France
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395 grid-institutes:grid.413328.f schema:alternateName Saint-Louis Hospital, Paris, France
396 schema:name Saint-Louis Hospital, Paris, France
397 rdf:type schema:Organization
398 grid-institutes:grid.413780.9 schema:alternateName Avicenne Hospital, Bobigny, France
399 schema:name Avicenne Hospital, Bobigny, France
400 rdf:type schema:Organization
401 grid-institutes:grid.418119.4 schema:alternateName Institut Jules Bordet, Brussels, Belgium
402 schema:name Institut Jules Bordet, Brussels, Belgium
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404 grid-institutes:grid.418443.e schema:alternateName Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
405 schema:name Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
406 rdf:type schema:Organization
 




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