Title :

Hepatic dysfunction impairs prognosis in critically ill patients with hematological malignancies: A post-hoc analysis of a prospective multicenter multinational dataset

Author(s) :

Bisbal, Magali [Auteur]
Darmon, Michael [Auteur]
Saillard, Colombe [Auteur]
Mallet, Vincent [Auteur]
Mouliade, Charlotte [Auteur]
Lemiale, Virginie [Auteur]
Benoit, Dominique [Auteur]
Pene, Frédéric [Auteur]
Kouatchet, Achille [Auteur]
Demoule, Alexandre [Auteur]
Vincent, François [Auteur]
Nyunga, Martine [Auteur]
Bruneel, Fabrice [Auteur]
Lebert, Christine [Auteur]
Renault, Anne [Auteur]
Meert, Anne-Pascale [Auteur]
Hamidfar, Rebecca [Auteur]
Jourdain, Mercedes [Auteur]
Hôpital Roger Salengro [Lille]
Recherche translationnelle sur le diabète (RTD) - U1190
Azoulay, Elie [Auteur]
Mokart, Djamel [Auteur]

Journal title :

Journal of Critical Care

Abbreviated title :

J Crit Care

Volume number :

62

Pages :

88-93

Publisher :

WB Saunders

Publication date :

2021-04

ISSN :

0883-9441

English keyword(s) :

Hepatic dysfunction
Hyperbilirubinemia
Outcome
Critically ill patient
Hematological malignancies

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Purpose Hyperbilirubinemia is frequent in patients with hematological malignancies admitted to the intensive care unit (ICU). Literature about hepatic dysfunction (HD) in this context is scarce. Methods We investigated ...
Show more >Purpose Hyperbilirubinemia is frequent in patients with hematological malignancies admitted to the intensive care unit (ICU). Literature about hepatic dysfunction (HD) in this context is scarce. Methods We investigated the prognostic impact of HD analyzing a prospective multicenter cohort of 893 critically ill hematology patients. Two groups were defined: patients with HD (total bilirubin ≥33 μmol/L at ICU admission) and patients without HD. Results Twenty one percent of patients were found to have HD at ICU admission. Cyclosporine, antimicrobials before ICU admission, abdominal symptoms, ascites, history of liver disease, neutropenia, increased serum creatinine and myeloma were independently associated with HD. Etiology remained undetermined in 73% of patients. Hospital mortality was 56.3% and 36.3% respectively in patients with and without HD (p < 0.0001). Prognostic factors independently associated with hospital mortality in HD group were, performance status >1 (OR = 2.07, 95% CI = 1.49–2.87, p < 0.0001), invasive mechanical ventilation (OR = 3.92, 95% CI = 2.69–5.71, p < 0.0001), renal replacement therapy (OR = 1.74, 95% CI = 1.22–2.47, p = 0.002), vasoactive drug (OR = 1.81, 95% CI = 1.21–2.71, p = 0.004) and SOFA score without bilirubin level at ICU admission (OR = 1.09, 95% CI = 1.04–1.14, p < 0.0001). Conclusions HD is common, underestimated, infrequently investigated, and is associated with impaired outcome in critically ill hematology patients. HD should be considered upon ICU admission and managed as other organ dysfunctions.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Recherche translationnelle sur le diabète (RTD) - U1190

Submission date :

2024-01-19T23:16:55Z
2024-09-17T14:33:14Z