Abstract | BACKGROUND: METHODS: RESULTS: Overall hospital mortality was 83%. Major organ system dysfunction, as measured by the acute physiology score (APS) of the APACHE III prognostic system, was significantly (P < 0.05) related to hospital mortality. Three disease-specific clinical characteristics were predictive of mortality: 1) stage beyond first complete remission, 2) duration of neutropenia greater than 30 days, and 3) treatment with bone marrow transplantation, especially if HLA-mismatched. None of the 15 (10%) patients with neutropenia greater than 30 days or the four patients who underwent HLA-mismatched transplantation survived to discharge. Age was also a significant predictor of hospital mortality. CONCLUSIONS: Overall outcome of patients with hematologic malignancy and acute respiratory failure is poor. A larger prospective study will be required to confirm the relative value of disease-specific variables identified in this study when combined with established predictive variables. In the future, it may be possible to develop a predictive instrument that is specifically tailored for patients with hematologic malignancy who develop respiratory failure.
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Authors | D E Epner, P White, M Krasnoff, S Khanduja, K T Kimball, W A Knaus |
Journal | Journal of investigative medicine : the official publication of the American Federation for Clinical Research
(J Investig Med)
Vol. 44
Issue 5
Pg. 254-60
(Jun 1996)
ISSN: 1081-5589 [Print] England |
PMID | 8763976
(Publication Type: Journal Article)
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Topics |
- APACHE
- Adult
- Baltimore
(epidemiology)
- Combined Modality Therapy
- Female
- Humans
- Leukemia
(complications, mortality, therapy)
- Lymphoma
(complications, mortality, therapy)
- Male
- Middle Aged
- Prognosis
- Respiration, Artificial
- Respiratory Insufficiency
(etiology, mortality, therapy)
- Survivors
(statistics & numerical data)
- Time Factors
- Treatment Outcome
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