Quintana Jhon H, López-Vanegas Cesar David, Rivas-Tafurt Giovanna Patricia, Ordoñez-Mora Leidy Tatiana, Lozada-Ramos Heiler, Daza-Arana Jorge Enrique
Internal Medicine Specialization Program, Department of Health, Universidad Santiago de Cali, Santiago de Cali 760035, Colombia.
Genetics, Physiology, and Metabolism Research Group (GEFIME), Universidad Santiago de Cali, Santiago de Cali 760035, Colombia.
Curr Oncol. 2025 Feb 26;32(3):132. doi: 10.3390/curroncol32030132.
Hematooncology patients admitted to intensive care units (ICUs) are at high risk for mortality due to the severity of their critical illness. Such complications can develop into complex clinical management, thus signaling an urgent need to identify mortality-related factors to improve interventions and outcomes for these patients.
A systematic review of studies published between 2012 and 2023 in databases such as PubMed, Scopus, and Web of Science was conducted, following the PRISMA guidelines. A meta-analysis was carried out to determine the significance of mortality-related factors.
In a review of twenty-four studies, it was found that invasive mechanical ventilation (IMV) was associated with an odds ratio (OR) between 2.70 and 8.26 in 75% of the studies. The use of vasopressor support had an OR of 6.28 in 50% of the studies, while pulmonary involvement by tumor had an OR of 6.73 in 30% of the studies. Sepsis showed an OR of 5.06 in 60% of the studies, and neutropenia upon admission increased mortality in 40% of the studies. Severe respiratory failure (PaO/FiO < 150) had an OR of 7.69 in 55% of the studies. Additionally, ICU readmission and late admission were identified as risk factors for increased mortality.
Mortality among hematooncology ICU patients is associated with IMV, vasopressor support, pulmonary involvement, sepsis, neutropenia, severe respiratory failure, ICU readmission, and late admission. Identifying and managing these factors in a timely manner can improve survival and the quality of care.
入住重症监护病房（ICU）的血液肿瘤患者因其危重病的严重性而面临高死亡风险。此类并发症会发展为复杂的临床管理问题，因此迫切需要识别与死亡相关的因素，以改善对这些患者的干预措施和治疗结果。
按照PRISMA指南，对2012年至2023年期间在PubMed、Scopus和Web of Science等数据库中发表的研究进行了系统综述。进行荟萃分析以确定与死亡相关因素的显著性。
在对24项研究的综述中发现，在75%的研究中，有创机械通气（IMV）的比值比（OR）在2.70至8.26之间。在50%的研究中，使用血管活性药物支持的OR为6.28，而在30%的研究中，肿瘤累及肺部的OR为6.73。在60%的研究中，脓毒症的OR为5.06，入院时中性粒细胞减少在40%的研究中增加了死亡率。在55%的研究中，严重呼吸衰竭（PaO/FiO<150）的OR为7.69。此外，ICU再入院和延迟入院被确定为死亡率增加的危险因素。
血液肿瘤ICU患者的死亡率与IMV、血管活性药物支持、肺部受累、脓毒症、中性粒细胞减少、严重呼吸衰竭、ICU再入院和延迟入院有关。及时识别和管理这些因素可以提高生存率和护理质量。
