Haematology Department, Annecy Hospital, Epagny-Metz-Tessy, France.
Intensive Care Unit, Annecy Hospital, Epagny-Metz-Tessy, France.
Eur J Haematol. 2024 Sep;113(3):330-339. doi: 10.1111/ejh.14228. Epub 2024 May 23.
This study aimed to determine whether implementing a rapid response system (RRS) is associated with improved short-term outcomes in critically ill patients with haematological malignancies.
Our monocentric pre- versus post-intervention study was conducted between January 2012 and April 2020. RRS was activated at early signs of haemodynamic or respiratory failure. The primary outcome was the reduction in Sequential Organ Failure Assessment (SOFA) score on Day 3 after intensive care unit (ICU) admission. Secondary outcomes included time to ICU admission and mortality.
A total of 209 patients with a median age of 59 years were enrolled (108 in the pre-intervention period and 101 in the post-intervention period). 22% of them had received an allogeneic transplant. The post-intervention period was associated with a shorter time to ICU admission (195 vs. 390 min, p < .001), a more frequent favourable trend in SOFA score (57% vs. 42%, adjusted odds ratio, 2.02, 95% confidence interval, 1.09 to 3.76), no significant changes in ICU (22% vs. 26%, p = .48) and 1-year (62% vs. 58%, p = .62) mortality rates.
Detection of early organ failure and activation of an RRS was associated with faster ICU admission and lower SOFA scores on Day 3 of admission in critically ill patients with haematological malignancies.
本研究旨在确定快速反应系统（RRS）的实施是否与血液恶性肿瘤重症患者的短期预后改善相关。
我们的单中心前瞻性研究于 2012 年 1 月至 2020 年 4 月进行。RRS 在出现血流动力学或呼吸衰竭的早期迹象时启动。主要结局是重症监护病房（ICU）入院后第 3 天的序贯器官衰竭评估（SOFA）评分降低。次要结局包括 ICU 入院时间和死亡率。
共纳入 209 例中位年龄为 59 岁的患者（干预前 108 例，干预后 101 例）。其中 22%接受过同种异体移植。干预后 ICU 入院时间更短（195 分钟 vs. 390 分钟，p < 0.001），SOFA 评分更常出现有利趋势（57% vs. 42%，调整后优势比 2.02，95%置信区间 1.09 至 3.76），ICU 入住率（22% vs. 26%，p = 0.48）和 1 年死亡率（62% vs. 58%，p = 0.62）无显著变化。
检测早期器官衰竭并激活 RRS 与血液恶性肿瘤重症患者 ICU 入院更快和入院第 3 天 SOFA 评分降低相关。
