Mortality-Related Risk Factors in Patients with Hematologic Neoplasm Admitted to the Intensive Care Unit: A Systematic Review.

Abstract

Background: 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.

Methods: 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.

Results: 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 (PaO₂/FiO₂ < 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.

Conclusions: 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.