Predictors of ICU mortality in patients with hemoblastosis and infectious complications

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OBJECTIVE

To identify predictors of ICU mortality in patients with hemoblastosis and infectious complications.

MATERIAL AND METHODS

The study included 202 ICU patients with hemoblastosis and infectious complications between 2018 and 2021. We evaluated SIRS, qSOFA and SOFA scores, as well as other potential significant predictors. Binomial multiple logistic regression approach was used to create prognostic model.

RESULTS

Mortality rate was 33% (67 out of 202), odds ratio — 0.49 (67 to 136). The median of the follow-up period was 6 (3-14) days. Univariate analysis revealed tachypnea, hypoxemia, hemodynamic instability (blood pressure decrease, need for vasopressor support), liver damage (hyperbilirubinemia, hypoproteinemia, hypoalbuminemia) and impaired consciousness as predictors of ICU mortality. Multivariate analysis revealed 3 significant predictors of mortality: impaired consciousness, platelet count and serum protein. Model quality was evaluated on a test set with a threshold of high probability of death ≥32%. Accuracy was 0.816 (95% CI 0.679-0.912), sensitivity — 0.80, specificity — 0.82.

CONCLUSION

Impaired consciousness, decreased platelet count and serum protein are the most important predictors of mortality in ICU patients with hemoblastosis and infectious complications. These data can be used in clinical practice.

Keywords:

sepsis

prognosis

mortality

leukemia

lymphoma

Authors:

Lyanguzov A.V.

Kirov Research Institute of Hematology and Blood Transfusion of the FMBA of Russia

Luchinin A.S.

Kirov Research Institute of Hematology and Blood Transfusion

Ignatyev S.V.

Kirov Research Institute of Hematology and Blood Transfusion of the FMBA of Russia

Paramonov I.V.

Kirov Research Institute of Hematology and Blood Transfusion of the FMBA of Russia

Received:

12.05.2022

Accepted:

21.06.2022

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