Predictors of mortality among patients with acute leukemias admitted to an intensive care unit specialized in patients with hematological disease at a Brazilian hospital

tIntroduction: Hematologists deal every day with high mortality rates of acute leukemiapatients. Many times these patients need Intensive Care Unit (ICU) support and some gen-eral ICU teams believe that these patients have a much greater chance of dying than patientswith other pathologies. In Brazil, data related to mortality rates and ICUs for acute leukemiapatients are scarce.Methods: Therefore, to assess mortality predictors in patients with acute leukemia admittedto a specialized hematological ICU, we evaluated demographics, supportive care, hospi-talization time, disease status, admitting diagnosis, neutropenia, number of transfusionsand Acute Physiology and Chronic Health Evaluation (APACHE)/Sepsis Related Organ Fail-ure Assessment (SOFA) scores as possible factors associated with mortality. Data wereextracted from the first admission records of 110 patients with acute leukemia admittedto the Hemocentro de Pernambuco (Hemope) ICU between 2006 and 2009.Results: In this retrospective cohort study, 72/110 of the patients were men, and 64/110 werefrom the metropolitan area of Recife. The patients’ age median was 43.5 years (±17.9); 67.3%had acute myeloid leukemia (AML) and 32.7% had acute lymphoid leukemia. The mainadmitting diagnosis in the ICU was sepsis (66.7%). The mean APACHE II score was 18.3.Of the total, 65 (59%) died, and the mortality rate was independently related to longer hos-pitalization (p < 0.001), the increase in the APACHE II score (p < 0.038) and having receivedhemodialysis (p < 0.006). Neutropenia, receiving multiple transfusions and using any kindof mechanical ventilation or vasoactive drug on admission were not relevant to mortality.Factors associated with higher mortality rates were: longer hospitalization, increase in theAPACHE II score, and use of hemodialysis.