ArticlePloS one2017
Neurological failure in ICU patients with hematological malignancies: A prospective cohort study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mortality-Related Risk Factors in Patients with Hematologic Neoplasm Admitted to the Intensive Care Unit: A Systematic Review.Current oncology (Toronto, Ont.) · 2025Pooled it
- When and for Whom Does Intensive Care Unit Admission Change the Prognosis in Oncology?-A Scoping Review.Cancers · 2025Review
- Understanding cancer disease status and what it means for intensivists.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Acute neurological dysfunction in critically ill patients with solid tumors: A 14-year retrospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- The 10 signs telling me that my cancer patient in the emergency department is at high risk of becoming critically ill.Intensive care medicine · 2018Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEpidemiological studies of neurological complications in patients with hematological malignancies are scant. The objective of the study was to identify determinants of survival in patients with hematological malignancy and neurological failure.
methodsPost hoc analysis of a prospective study of adults with hematological malignancies admitted for any reason to one of 17 university or university-affiliated participating ICUs in France and Belgium (2010-2012). The primary outcome was vital status at hospital discharge.
resultsOf the 1011 patients enrolled initially, 226 (22.4%) had neurological failure. Presenting manifestations were dominated by drowsiness or stupor (65%), coma (32%), weakness (26%), and seizures (19%). Neuroimaging, lumbar puncture, and electroencephalography were performed in 113 (50%), 73 (32%), and 63 (28%) patients, respectively. A neurosurgical biopsy was done in 1 patient. Hospital mortality was 50%. By multivariate analysis, factors independently associated with higher hospital mortality were poor performance status (odds ratio [OR], 3.99; 95%CI, 1.82-9.39; P = 0.0009), non-Hodgkin's lymphoma (OR, 2.60; 95%CI, 1.35-5.15; P = 0.005), shock (OR, 1.95; 95%CI, 1.04-3.72; P = 0.04), and respiratory failure (OR, 2.18; 95%CI, 1.14-4.25; P = 0.02); and factors independently associated with lower hospital mortality were GCS score on day 1 (OR, 0.88/point; 95%CI, 0.81-0.95; P = 0.0009) and autologous stem cell transplantation (OR, 0.25; 95%CI, 0.07-0.75; P = 0.02).
conclusionsIn ICU patients with hematological malignancies, neurological failure is common and often fatal. Independent predictors of higher hospital mortality were type of underlying hematological malignancy, poor performance status, hemodynamic and respiratory failures, and severity of consciousness impairment. Knowledge of these risk factors might help to optimize management strategies.
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