Long-Term Outcome of Patients With a Hematologic Malignancy and Multiple Organ Failure Admitted at the Intensive Care

Vera A. de Vries*, Marcella C. A. Mueller, M. Sesmu Arbous, Bart J. Biemond, Nicole Blijlevens, Nuray Kusadasi, Lambert R. F. Span, Alexander P. J. Vlaar, David J. van Westerloo, Hanneke C. Kluin-Nelemans, Walter M. van den Bergh, Pieter Roel Tuinman, Angelique Spoelstra, Erik Marijt, Murielle Hilkens, Jelle Epker, Annoek Broers, Goda Choi, Astrid Demandt, Walther van MookHEMA-ICU Study Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives: Historically, patients with a hematologic malignancy have one of the highest mortality rates among cancer patients admitted to the ICU. Therefore, physicians are often reluctant to admit these patients to the ICU. The aim of our study was to examine the survival of patients who have a hematologic malignancy and multiple organ failure admitted to the ICU. Design: This retrospective cohort study, part of the HEMA-ICU study group, was designed to study the survival of patients with a hematologic malignancy and organ failure after admission to the ICU. Patients were followed for at least 1 year. Setting: Five university hospitals in the Netherlands. Patients: One-thousand ninety-seven patients with a hematologic malignancy who were admitted at the ICU. Interventions: None. Measurements and Main Results: Primary outcome was 1-year survival. Organ failure was categorized as acute kidney injury, respiratory failure, hepatic failure, and hemodynamic failure; multiple organ failure was defined as failure of two or more organs. The World Health Organization performance score measured 3 months after discharge from the ICU was used as a measure of functional outcome. The 1-year survival rate among these patients was 38%. Multiple organ failure was inversely associated with long-term survival, and an absence of respiratory failure was the strongest predictor of 1-year survival. The survival rate among patients with 2, 3, and 4 failing organs was 27%, 22%, and 8%, respectively. Among all surviving patients for which World Health Organization scores were available, 39% had a World Health Organization performance score of 0-1 3 months after ICU discharge. Functional outcome was not associated with the number of failing organs. Conclusions: Our results suggest that multiple organ failure should not be used as a criterion for excluding a patient with a hematologic malignancy from admission to the ICU.

Original languageEnglish
Pages (from-to)E120-E128
Number of pages9
JournalCritical Care Medicine
Issue number2
Publication statusPublished - Feb 2019


  • hematologic malignancy
  • intensive care unit
  • multiple organ failure/mortality
  • organ failure
  • prognosis
  • UNIT

Cite this