Factors affecting the course and prognosis of hematopoietic stem cell transplant recipients admitted to The Medical Intensive Care Unit in Gazi University Hospital

Hematopoietic Stem Cell Transplantation (HSCT), is a treatment modality with high morbidity and mortality. Some of the transplantation associated complications may require admission to intensive care units. The outcome for HSCT patients requiring intensive care unit admission is usually poor.We aimed to investigate the factors affecting the course and prognosis of HSCT patients requiring intensive care unit admission at a university hospital in this study.HSCT patients requiring intensive care unit admission between 01.01.2007-31.12.2010 were analyzed retrospectively.During the study period, 64 patients were admitted to the medical ICU. According to the study inclusion criteria, advanced statistical analysis was performed in 48 patients. The most common reason for ICU admission was identified as respiratory failure.Factors affecting mortality in univariate analysis were the presence of VOD, disease relapse, APACHE II and SOFA scores, isolation of bacteria and septic shock on admission to the ICU.Modalities of treatment and follow-up in the ICU, such as requirement of intubation, IMV application, vasopressor use, CVP and invasive arterial blood pressure monitoring and application of renal replacement therapy were found to be associated with increased mortality.Among complications that occurred in the ICU, 100% mortality was attributed to pneumonia, septic shock and MODS.The prognostic factors affecting mortality in univariate analysis were re-evaluated with logistic regression analysis and the statistical significance of the vasopressor requirement and the APACHE II score was maintained (p value<0,05).We found that discharge from intensive care unit or transfer to the other services defined as short-term survival rate was 31,25% and a one-year survival rate was 14,6%.