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脓毒症相关器官功能衰竭评估(SOFA)评分可预测异基因造血干细胞移植后入住重症监护病房患者的生存率。

The sepsis-related Organ Failure Assessment (SOFA) score is predictive for survival of patients admitted to the intensive care unit following allogeneic blood stem cell transplantation.

作者信息

Neumann Frank, Lobitz Oliver, Fenk Roland, Bruns Ingmar, Köstering Matthias, Steiner Stefan, Hennersdorf Marcus, Kelm Malte, Strauer Bodo Eckehard, Germing Ulrich, Hinke Axel, Haas Rainer, Kobbe Guido

机构信息

Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.

出版信息

Ann Hematol. 2008 Apr;87(4):299-304. doi: 10.1007/s00277-008-0440-9. Epub 2008 Jan 25.

Abstract

Intensive care unit (ICU) support following allogeneic peripheral blood stem cell transplantation (PBSCT) is controversial due to the limited prognosis of these patients in case of secondary critical illness. In this retrospective single centre study, we looked for factors predicting survival in patients who needed ICU support after myeloablative (MAC) or non-myeloablative conditioning (non-MAC) therapy and allogeneic PBSCT. Between 1999 and 2006, 64 out of 319 patients following allogeneic PBSCT were admitted to the ICU (24 female and 40 male patients, median age 47 years, range 17-65 years; MAC 49 patients, non-MAC 15 patients). All 64 patients required mechanical ventilation. We looked for variables defining the Sepsis-related Organ Failure Assessment (SOFA) score as well as for baseline characteristics and transplant-associated parameters on the day of ICU admission possibly predictive for poor or good survival prognosis. Nineteen of 49 patients who had received MAC therapy survived the ICU stay for a median time of 9 months (range 2-29 months) and three of 15 patients who had received non-MAC therapy could be discharged from the ICU with a survival time of 4, 5 and 12 months. After univariate and multivariate analysis the SOFA score discriminated survivors and non-survivors of the ICU stay. We conclude that the SOFA score is predictive for survival when applied on the day of ICU admission.

摘要

异基因外周血干细胞移植(PBSCT)后重症监护病房(ICU)支持存在争议,因为这些患者在继发危重病时预后有限。在这项回顾性单中心研究中,我们寻找了接受清髓性(MAC)或非清髓性预处理(非MAC)治疗及异基因PBSCT后需要ICU支持的患者的生存预测因素。1999年至2006年间,319例异基因PBSCT患者中有64例入住ICU(24例女性和40例男性患者,中位年龄47岁,范围17 - 65岁;MAC组49例患者,非MAC组15例患者)。所有64例患者均需要机械通气。我们寻找定义脓毒症相关器官功能衰竭评估(SOFA)评分的变量,以及ICU入院当天可能预测生存预后好坏的基线特征和移植相关参数。接受MAC治疗的49例患者中有19例在ICU住院期间存活,中位时间为9个月(范围2 - 29个月),接受非MAC治疗的15例患者中有3例可从ICU出院,生存时间分别为4、5和12个月。经过单因素和多因素分析,SOFA评分可区分ICU住院的幸存者和非幸存者。我们得出结论,在ICU入院当天应用SOFA评分可预测生存情况。

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