Department of Emergency, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Ping An Life Insurance of China, Shenzhen, Guangdong, People's Republic of China.
Hematology. 2020 Dec;25(1):433-437. doi: 10.1080/16078454.2020.1845502.
This study aimed to analyze clinical characteristics and outcomes of critically ill patients with multiple myeloma (MM) admitted to the intensive care unit (ICU) and identify predictors of poor short-term prognosis. Data for patients with MM admitted to the ICU were extracted from the Medical Information Mart for Intensive Care III database. The risk factors leading to the ICU and hospital mortality were evaluated using logistic regression analysis. Of 126 patients identified, 17 (13.5%) and 37 (29.4%) died in the ICU and hospital, respectively. Patients with ICU mortality showed higher median blood urea nitrogen (57.0 29.0) and poorer Acute Physiology Scores (APS, 70.0 . 46.0) than did surviving patients on the day of ICU admission. In-ICU deceased patients had higher proportion of mechanical ventilation (64.7% 26.6%) and vasopressor use (64.7% 17.4%) at admission and positive pathogenic culture during ICU stay (58.8% . 19.3%). The APS and positive pathogenic culture were independent prognostic factors for ICU mortality, while risk factors for hospital mortality included higher APS and relapsed/refractory disease. The short-term prognoses for patients with MM admitted to the ICU were mainly determined by the severity of organ failure, infection, and disease status.
本研究旨在分析入住重症监护病房(ICU)的多发性骨髓瘤(MM)危重症患者的临床特征和转归,并确定不良短期预后的预测因素。从医疗信息集市重症监护 III 数据库中提取入住 ICU 的 MM 患者的数据。使用逻辑回归分析评估导致 ICU 和医院死亡的危险因素。在确定的 126 例患者中,分别有 17 例(13.5%)和 37 例(29.4%)在 ICU 和医院死亡。与存活患者相比,在 ICU 死亡的患者在 ICU 入住当天的中位血尿素氮(57.0 29.0)和急性生理学评分(APS,70.0. 46.0)更高。在 ICU 死亡的患者在入院时接受机械通气(64.7% 26.6%)和血管加压素使用(64.7% 17.4%)的比例更高,在 ICU 期间培养出阳性致病微生物的比例也更高(58.8%. 19.3%)。APS 和阳性致病微生物培养是 ICU 死亡率的独立预后因素,而医院死亡率的危险因素包括更高的 APS 和复发性/难治性疾病。入住 ICU 的 MM 患者的短期预后主要由器官衰竭、感染和疾病状态的严重程度决定。