Characteristics and Hospital Outcomes of Patients Admitted to the Intensive Care Unit Because of Haematological Malignancy—A Service Evaluation

Abstract

Introduction: Intensive care unit (ICU) admission due to haematological malignancy (HM) has previously been questioned due to high mortality. While mortality-associated factors have been studied in HM patients to guide decision making and clinical practice, UK-based research remains limited. This single-centre retrospective service evaluation (SE) aimed to review characteristics and hospital outcomes of patients admitted to our ICU because of HM.

Methods: Consecutive adults with HM-related admissions to a multi-specialty ICU between January 2022 and October 2024 were retrospectively identified. Data were extracted for patient characteristics, ICU interventions and hospital outcomes. Associations with ICU mortality rates were also assessed.

Results: During the SE, there were 227 ICU admissions of HM patients, of which 168 were HM-related and, hence, included in subsequent analysis. The most common reasons for admission were respiratory failure (36.3%) and sepsis (26.2%). ICU and in-hospital mortality rates were 44.0% and 53.0%, respectively. ICU mortality rates increased significantly with APACHE II and SOFA scores (both p < 0.001), and in patients with leukaemia (p = 0.021), graft versus host disease (p = 0.001), treatment limitations (p < 0.001) or that were chemotherapy naïve (p = 0.044). In patients surviving to ICU discharge, 31.9% were unable to mobilise out of bed at this point. By hospital discharge, 94.9% of surviving patients were mobile; however, 25.3% required ongoing rehabilitation.

Conclusion: This SE describes the characteristics, outcomes and mortality-associated factors in patients with HM-related admissions to our ICU, which may be useful in aiding clinician understanding and guiding future practice. Prospective, robust studies are needed to validate findings and explore future opportunities to enhance patient outcomes in this cohort.

Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.