新诊断淋巴瘤患者入住重症监护病房后的预后情况。
Outcomes after intensive care unit admission of patients with newly diagnosed lymphoma.
作者信息
Algrin Caroline, Faguer Stanislas, Lemiale Virginie, Lengliné Etienne, Boutboul David, Amorim Sandy, Galicier Lionel, Canet Emmanuel, Thieblemont Catherine, Azoulay Elie
机构信息
Medical Intensive Care Unit.
出版信息
Leuk Lymphoma. 2015 May;56(5):1240-5. doi: 10.3109/10428194.2014.922181. Epub 2014 Oct 9.
No data are available on outcomes of patients with lymphoma requiring intensive care unit (ICU) admission. We retrospectively studied 190 patients admitted to our ICU between 2000 and 2010, before or during the first chemotherapy course for lymphoma. Reasons for ICU admission were renal failure (36%), shock (28%), respiratory failure (26%), coma (22%) and monitoring (12%). Mechanical ventilation was needed in 45% of patients, dialysis in 41% and vasoactive drugs in 30%. ICU, hospital and 1-year mortality rates were 22%, 37% and 51%. By multivariate analysis, factors associated with higher hospital mortality were age > 50 years (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.02-4.9), poor performance status (OR, 3.36; 95% CI, 1.47-6.54), high Sequential Organ Failure Assessment (SOFA) score (OR, 1.15/point; 95% CI, 1.04-1.27), hemophagocytic syndrome (OR, 2.57; 95% CI, 1.03-6.40), Burkitt lymphoma (OR, 3.36; 95% CI, 1.38-8.19) and primary cerebral lymphoma (OR, 7.32; 95% CI, 1.06-50.54). Admission after 2004 was associated with better survival (OR, 0.35; 95% CI, 0.15-0.78).
关于需要入住重症监护病房（ICU）的淋巴瘤患者的预后情况，目前尚无相关数据。我们回顾性研究了2000年至2010年间入住我院ICU的190例淋巴瘤患者，这些患者处于首次化疗疗程之前或期间。入住ICU的原因包括肾衰竭（36%）、休克（28%）、呼吸衰竭（26%）、昏迷（22%）以及监测（12%）。45%的患者需要机械通气，41%的患者需要透析，30%的患者需要使用血管活性药物。ICU死亡率、医院死亡率和1年死亡率分别为22%、37%和51%。多因素分析显示，与较高医院死亡率相关的因素包括年龄>50岁（比值比[OR]，2.23；95%置信区间[CI]，1.02 - 4.9）、体能状态差（OR，3.36；95%CI，1.47 - 6.54）、序贯器官衰竭评估（SOFA）评分高（OR，1.15/分；95%CI，1.04 - 1.27）、噬血细胞综合征（OR，2.57；95%CI，1.03 - 6.40）、伯基特淋巴瘤（OR，3.36；95%CI，1.38 - 8.19）以及原发性中枢神经系统淋巴瘤（OR，7.32；95%CI，1.06 - 50.54）。2004年后入院与更好的生存率相关（OR，0.35；95%CI，0.15 - 0.78）。
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