Background
Methods
Data sources
Selection criteria
Inclusion criteria | Exclusion criteria |
---|---|
• English language only • Human research subjects with a hematological malignancy (>50% of study sample) • Adult patients (≥18 years of age) • Primary research • Peer reviewed articles • Studies from January 2004 to November 2014 • Prognostic studies (cohort or case-control) • Median survival of ≤ 3 months, (or >50% sample had died in ICU, or in hospital or within 3 months) • Reported ‘bedside prognostic factors’ | • Editorials and letters • Discussions / expert opinion papers • Non - peer reviewed • Reports of clinical trials evaluating the effects of a specific treatment (chemotherapy, radiation therapy, etc.) • Systematic reviews of original research (predictive/prognostic cohort studies) |
Quality assessment
Analysis
Results
Study selection
Study characteristics
Author, Year, Country | Design | Sample characteristics | Hem malig | N | Analysis | Quality rating (QUIPS) |
---|---|---|---|---|---|---|
Rabe et al., (2004) Germany [41] | Retro | Admitted to ICU, with pulmonary infiltrates, requiring ventilation | AML | 30 | Uni - | Mod |
Soubani et al., (2004) USA [30] | Retro | Admitted to ICU | HSCT | 85 | Uni Multi | Mod |
BaHammam et al. (2005) Saudi Arabia [51] | Retro | Admitted to ICU | All | 44 | Uni - | Mod |
Owczuk et al., (2005) Poland [37] | Retro | Admitted to ICU, requiring ventilation | HSCT | 40 | Uni Multi | Mod |
Naeem et al., (2006) USA [34] | Retro | Admitted to ICU | Cord HSCT | 44 | Uni - | Mod |
Ferra et al., (2006) Spain [46] | Retro | Admitted to ICU | All | 100 | Uni Multi | Mod |
Lim et al., (2007) UK [33] | Retro | Admitted to ICU | All | 55 | Uni - | Mod |
Yang et al., (2007) Taiwan [31] | Retro | Admitted to ICU, requiring ventilation | HSCT | 41 | Uni - | Mod |
Nishida & Palalay, (2008) USA [36] | Retro | Admitted to ICU, requiring ventilation | All | 37 | Uni - | Mod |
Park et al., (2008) Korea [38] | Retro | Admitted to ICU for septic shock | Acute leuk | 50 | Uni Multi | High |
Chen et al., (2009) Taiwan [54] | Retro | Intracranial hemorrhage (in-patient acute setting) | AML | 51 | Uni Multi | High |
Hampshire et al., (2009) UK [48] | Retro | Admitted to ICU (multi-centre) | All | 7689 | - Multi | Mod |
des Ordons et al., (2010) USA [44] | Retro | Admitted to ICU | AML | 45 | Uni - | High |
Burghi et al., (2011) France [53] | Retro | Admitted to ICU, invasive pulmonary aspergillosis, ventilated | All | 67 | Uni Multi | High |
Depuydt et al., (2011) Belgium [43] | Pro | Admitted to ICU | Allo HSCT | 44 | Uni Multi | Mod |
Geerse et al., (2011) Netherlands [47] | Retro | Admitted to ICU | All | 86 | Uni Multi | Mod |
Park et al., (2011) Korea [39] | Retro | Admitted to ICU, with AKI, requiring RRT | All | 94 | Uni Multi | Mod |
Ramos et al., (2011) USA [55] | Retro | Invasive aspergillosis (in-patient acute setting) | HSCT | 449 | Uni Multi | Mod |
Agarwal et al. (2012) Australia [50] | Retro | Admitted to ICU | HSCT | 146 | Uni Multi | High |
Ferra et al., (2012) Spain [45] | Retro | Admitted to ICU | Lymphoma | 48 | Uni Multi | Low |
Hill et al., (2012) UK [49] | Retro | Admitted to ICU (multi-centre) | All | 147 | Uni Multi | Mod |
Yeo et al., (2012) Korea [32] | Retro | Admitted to ICU | All | 227 | Uni Multi | Mod |
Corbett et al., (2013) Australia [56] | Retro | Referred to specialist palliative care service (in-pt. & out-pt. setting) | All | 276 | - Multi | Mod |
de Montmollin et al., (2013) France [42] | Retro | Admitted to ICU, with septic shock, pulmonary origin (multi-centre) | All | 218 | Uni Multi | Mod |
Namendys-Silva et al., (2013) Mexico [35] | Pro | Admitted to ICU | All | 102 | Uni Multi | Mod |
Price et al., (2013) USA [40] | Retro | Admitted to ICU, requiring ventilation | Acute leuk | 167 | Uni Multi | Mod |
Kripp et al., (2014) Germany [57] | Pros | Admitted to palliative care unit | All | 290 | Uni Multi | Mod |
Boyaci et al., (2014) Turkey [52] | Retro | Admitted to ICU | HSCT | 48 | Uni Multi | Mod |
Quality of studies
Patient characteristics
Analysis in studies
Prognostic factors identified
Prognostic factor | Number of studies | Total # of pts., N | Univariate analysis Significant/ tested/% significant | Multivariable analysis Significant/ tested/% significant | Hematological malignancies tested |
---|---|---|---|---|---|
Older age | 22 | 10,027 | 6/20 (30%) | 5/16 (31%) | • Acute leukemia • All hematological malignancies • AML • Cord HSCT • HSCT |
Mechanical ventilation | 18 | 9702 | 13/17 (76%) | 12/14 (86%) | • Acute leukemia • All hematological malignancies Cord HSCT • HSCT • Lymphoma |
Vasopressors use | 15 | 1300 | 12/15 (80%) | 8/9 (89%) | • Acute leukemia • All hematological malignancies • AML • Cord HSCT • HSCT |
Renal replacement therapy | 7 | 633 | 3/7 (43%) | 3/4 (75%) | • All hematological malignancies • AML • HSCT |
Transfusions | 4 | 490 | 2/4 (50%) | 2/4 (50%) | • Acute leukemia • All hematological malignancies • HSCT |
Admission to intensive care unit | 1 | 85 | 1/1 (100%) | 1/1 (100%) | • HSCT |
Artificial feeding | 1 | 290 | 1/1 (100%) | 1/1 (100%) | • All hematological malignancies |
Opiate analgesia | 1 | 290 | 1/1 (100%) | 1/1 (100%) | • All hematological malignancies |
Sepsis/infection | 17 | 9170 | 9/16 (56%) | 8/14 (57%) | • Acute leukemia • All hematological malignancies • AML • HSCT • Lymphoma |
Hemodynamic instability | 9 | 8095 | 6/8 (75%) | 5/8 (62%) | • All hematological malignancies • AML • Cord HSCT • HSCT • Lymphoma |
Multi organ failure | 9 | 657 | 6/8 (75%) | 5/6 (83%) | • All hematological malignancies • HSCT |
Respiratory distress/failure | 13 | 8715 | 5/12 (42%) | 5/10 (50%) | • Acute leukemia • All hematological malignancies AML • Cord HSCT • HSCT • Lymphoma |
Cardiovascular function | 5 | 711 | 3/5 (60%) | 3/5 (60%) | • All hematological malignancies • HSCT • Acute leukemia |
Decreased level of consciousness | 10 | 1169 | 3/9 (33%) | 3/8 (37%) | • Acute leukemia • All hematological malignancies • HSCT • Lymphoma |
Renal dysfunction | 8 | 8205 | 2/6 (33%) | 2/3 (66%) | • Acute leukemia • All hematological malignancies • AML • Cord HSCT • HSCT • Lymphoma |
Fungal infection | 4 | 382 | 2/4 (50%) | 2/4 (50%) | • Acute leukemia • All hematological malignancies • HSCT |
Liver dysfunction | 7 | 478 | 3/7 (43%) | 3/4 (75%) | • Acute leukemia • AML • Cord HSCT • All hematological malignancies • HSCT |
Pneumonia | 4 | 173 | 2/4 (50%) | 0/1 (0%) | • All hematological malignancies • Cord HSCT • HSCT |
CMV reactivation | 1 | 86 | 1/1 100% | 0/1 0% | • All hematological malignancies |
Performance status | 4 | 775 | 1/4 (25%) | 1/4 (25%) | • Acute leukemia • All hematological malignancies |
Disease characteristics | |||||
Acute leukemia | 11 | 9352 | 2/10 (20%) | 4/10 (40%) | • All hematological malignancies • Cord HSCT • HSCT |
Relapse or advanced disease | 10 | 862 | 4/10 (40%) | 4/8 (50%) | • Acute leukemia • All hematological malignancies • AML • Cord HSCT • HSCT |
HSCT | 9 | 8617 | 1/8 (12%) | 1/7 (14%) | • All hematological malignancies • HSCT |
Laboratory values | |||||
Liver enzymes | 11 | 823 | 7/11 (64%) | 5/6 (83%) | • Acute leukemia • All hematological malignancies • AML • HSCT |
Urea or creatinine | 11 | 8294 | 5/10 (50%) | 3/7 (43%) | • Acute leukemia • All hematological malignancies • AML • Cord HSCT • HSCT |
Neutropenia or leukopenia | 15 | 9244 | 5/14 (36%) | 5/12 (42%) | • All hematological malignancies • AML • HSCT |
Thrombocytopenia | 10 | 8614 | 5/9 (55%) | 4/6 (67%) | • All hematological malignancies • AML • Cord HSCT • HSCT |
Coagulopathy | 8 | 512 | 4/7 (57%) | 3/4 (75%) | • Acute leukemia • All hematological malignancies • AML • HSCT • Lymphoma |
Anemia | 4 | 477 | 4/4 (100%) | 4/4 (100%) | • All hematological malignancies • HSCT |
Blood pH | 3 | 7960 | 2/3 (66%) | 2/2 (100%) | • All hematological malignancies |
Calcium | 2 | 338 | 2/2 (100%) | 2/2 (100%) | • All hematological malignancies • HSCT |
CRP | 3 | 368 | 2/3 (66%) | 2/2 (100%) | • All hematological malignancies • AML • HSCT |
Hematocrit | 4 | 7859 | 1/3 (33%) | 2/4 (50%) | • All hematological malignancies |
Hypoalbuminemia | 5 | 570 | 2/5 (40%) | 2/4 (50%) | • All hematological malignancies • AML • HSCT |
Lactate | 2 | 133 | 2/2 (100%) | 2/2 (100%) | • HSCT |
LDH | 2 | 7737 | 2/2 (100%) | 2/2 (100%) | • All hematological malignancies • HSCT |
Sodium | 2 | 338 | ½ (50%) | 2/2 (100%) | • All hematological malignancies • HSCT |
Bicarbonate | 1 | 48 | 1/1 (100%) | 1/1 (100%) | • HSCT |
Pro-calcitonin | 1 | 48 | 1/1 (100%) | 1/1 (100%) | • HSCT |
Uric acid | 1 | 48 | 1/1 (100%) | 1/1 (100%) | • HSCT |