The following is a summary of “Long-term survival and functional outcomes of critically ill patients with hematologic malignancies: a Canadian multicenter prospective study,” published in the March 2024 issue of Critical Care by Munshi, et al.

Researchers launched a retrospective study investigating the long-term survival and functional abilities of hematologic malignancy (HM) patients who experienced critical illness.

They included HM patients admitted to seven Canadian ICUs from 2018 to 2020. Survivors were monitored for 7 days, 6 months, and 12 months following discharge from the ICU. The primary emphasis was on survival at 12 months. Functional Independent Measure (FIM) and short form (SF)-36 were used to assess functional outcomes at 6 and 12 months and factors associated with 12-month survival.

They included 414 patients, with 35% of them being women. The middle age was 61 (range: 52-69), with a middle Sequential Organ Failure Assessment (SOFA) score of 9 (range: 6-12), and 22% showing moderate-to-severe frailty (clinical frailty scale [CFS] ≥ 6). 51% of cases showed signs of acute leukemia, 38% were diagnosed with lymphoma/multiple myeloma, and 40% had received a hematopoietic stem cell transplant (HCT). The top causes for admission to the ICU were acute respiratory failure (50%) and sepsis (40%). 49% (203 patients) of those discharged from the ICU were still alive at 7 days post-discharge. 21% of the total cohort survived for 12 months, with a survival rate of 43% among those who survived the ICU. At 7 days, 42% of survivors had moderate-to-severe frailty, decreasing to 14% at 6 months and 8% at 12 months. The middle value of FIM at 7 days was 80 with an interquartile range of 50 to 109. At both 6 and 12 months, physical function, pain, social function, mental health, and emotional well-being were lower than scores of populations matched for age and sex. Frailty, allogeneic HCT, kidney injury, and cardiac complications during ICU stay were linked to lower 12-month survival rates.

Investigators concluded that of critical HM patients, 49% survived 7 days post-ICU, 21% at 1 year. Survival linked to diagnosis, and frailty; survivors faced lasting functional and emotional/physical issues.

Source: link.springer.com/article/10.1007/s00134-024-07349-z