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Post-Transplant Events

Sequential Organ Failure Assessment predicts the outcome of SCT recipients admitted to intensive care unit

Bone Marrow Transplantation volume 45, pages 682–688 (2010)Cite this article

Abstract

We analyzed all patients undergoing allogeneic stem cell transplantation (ASCT) and transferred to the intensive care unit (ICU) from January 1995 to December 2005. During this period, 661 patients underwent ASCT at our center. A total of 91 patients were admitted to the ICU. Median time from ASCT to ICU admission was 69 days (−24 to 1572) and median stay at the ICU was 4 (1–60) days. The survival after transfer to the ICU at day 100 and at 1 year was 22 and 16%, respectively. Median Sequential Organ Failure Assessment (SOFA) score was 10 (1–17). Patients with SOFA score <8 (n=18) had a 44% survival compared with 17% with SOFA score 8–11 (n=30) and no survival with SOFA score >11 (n=20) (P=0.0002). None of the 14 retransplanted patients survived compared with 31% among patients after first ASCT (P=0.006). Patients receiving TBI had a lower survival compared with patients treated with chemotherapy only (14 vs 45%, P=0.02). Patients needing vasopressor support had a worse survival, 15 vs 41%, compared with patients without vasopressor treatment (P=0.01). In multivariate analysis of death, SOFA score was the only significant factor (P<0.001). In conclusion, SOFA score predicted prognosis in ASCT patients treated at the ICU.

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Acknowledgements

We thank the staff at the Centre for Allogeneic Stem Cell Transplantation and at the Department for Anesthesiology and Intensive Care Medicine for competent and compassionate care of the patients.

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Authors and Affiliations

  1. Department for Anaesthesiology and Intensive Care Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden

    K Gilli & H Hjelmqvist

  2. Department of Clinical Immunology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden

    M Remberger, O Ringden & J Mattsson

  3. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden

    H Hjelmqvist

  4. Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden

    O Ringden & J Mattsson

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  1. K Gilli
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Correspondence to J Mattsson.

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Gilli, K., Remberger, M., Hjelmqvist, H. et al. Sequential Organ Failure Assessment predicts the outcome of SCT recipients admitted to intensive care unit. Bone Marrow Transplant 45, 682–688 (2010). https://doi.org/10.1038/bmt.2009.220

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