혈액종양 중환자실 환자의 임상적 고찰
Clinical Study of Hematology Patients in Intensive Care Units
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Purpose: 연구는 중환자실에 입실한 혈액종양환자의 입실원인과 사망률, 사망원인, 질환상태, 치료과정을 분석하여 전문적인 Hematology Patient ICU care를 위한 기초조사를 제공하기 위함이다. Methods: 서울소재 종합병원 Hematology ICU에 입실한 환자 559명을 대상으로 IRB 심의를 거친 후향적 조사연구이며 수집된 자료는 SAS program을 이용하여 분석하였다. Results: CU 입실원인과 사망원원인은 Pneumonia, Sepsis순이었으며 퇴실상태는 사망 53.5%, 회복 39.9%, Hopeless 5%순이었다. IR 상태의 환자의 사망률이 CR상태의 환자와 MM, SAA, Lymphoma로 치료받는 환자보다 높았다. Pneumonia, Sepsis로 입실한 환자와 Ventilator, CRRT, 승압제 ,CPCR을 시행한 환자의 사망률이 높았다. Conclusion: 혈액종양환자는 Pneumonia, Sepsis의 원인으로 ICU에 입실하고 사망하며 사망률은 53.5%로 IR상태의 환자, Ventilator, CRRT를 시행한 환자의 사망률이 높았다
Abstract
Purpose: To improve professional intensive care by analyzing admission causes, causes of death, diseaseconditions, and treatment processes in patients with hematological malignancies admitted to intensive careunits (ICUs) in South Korea. Methods: This was a retrospective study approved by IRB, and conducted onadmission with 559 adults, in the hematology ICU of a hospital located in Seoul. The study was carried out fromApril 2009 to March 2012. Data were analyzed using SAS. Results: Pneumonia was the most frequent causeof ICU admission and death, followed by sepsis. The condition at discharge was death (53.6%), recovery(39.9%), or hopeless (5.1%). Mortality of patients in states of incomplete remission was higher than that ofpatients with complete remission and of patients with multiple myeloma, severe aplastic anemia, andlymphoma. Conclusion: Results show that pneumonia and sepsis are the most frequent causes of ICUadmission and for the death of patients with hematological malignancies. The most frequent status at dischargeof patients with hematological malignancies was death (53.6%), with mortality of patients at IncompleteRemission status, of mechanically ventilated patients, and of patients on continuous renal replacement therapy(CRRT) being higher than others.
참고문헌 (22)
- Shim YH, "Crinical survey of ICU patients", The Korean Society of Critical Care Medicine, 11(1), pp.49~56 (1996)
- 김유정, "중환자실 환자의 비계획적 재입실 위험 요인", 임상간호연구, 19(2), pp.265~274 (2013), 병원간호사회
- Jang YS, "Development of admission and discharge criteria in intensive care units", The Journal of Korean Academic Society of Adult Nursing, 13(2), pp.291~304 (2001)
- Song DH, "A study on the reason for and actual condition of unplanned ICU admission", 석사, pp.2002
- Kang CH, "The variation of risk adjusted mortality rates of intensive care units and its relevant factors analysis", pp.2009
- Bae NY, "Clinical effectiveness of asepsis and sterilzed room for acute myeloid leukemia patien's infection control", Journal of Korean Society of Quality Assurance in Health Care symposium; Journal of Korean Society of Quality Assurance in Health Care, pp.131~139 (2000)
- 박성훈, "중환자실에 입원하는 혈액종양 환자의 예후 예측에 있어 Simplified Acute Physiology Score 2 (SAPS 2)와 Sequential Organ Failure Assessment (SOFA) Score의 유용성", 대한중환자의학회지, 24(1), pp.4~10 (2009), 대한중환자의학회
- Yoon JH, "Clinical study of hematology patients in intensive care unit", St Mary's Hospital Symposium;2004 Nivenber; St Mary's Hospital.t Mary's Hospital Symposium (2004)
- Kim DJ, "Overview of hematology malignancy and Hematopoietic stem cell transplantation" (2001), St Mary's Hospital
- Escobar K, "Admission of hematopoietic cell transplantation patients to the intensive care unit at the pontificia universidad catolica de chile hospital", Biology of Blood and Marrow Transplantation (2014)[DOI]
- Scales DC, "Intensive care outcomes in bone marrow transplant recipients: A population-based cohort analysis", Critical Care, 12(3), pp.77~85 (2008)[DOI]
- Parakh S, "Outcomes of haematology", oncology patients admitted to intensive care unit at the Canberra hospital, 2014, pp.44(11), 1087~1094
- Cherif H, "Predictors of short and long-term outcome in patients with hematologycal disorders admitted to the intensive care unit for a life-threatening complication", Suppot Care in Cancer, 15(12), pp.1393~1398 (2007)[DOI]
- Park MR, "Outcomes in critically ill patients with hematologic malignancies who received renal replacement therapy for acute kidney injury in an intensive care unit", Journal of Critical Care, 26(1), pp.107.e1~107.e6 (2011)[DOI]
- 황은아, "중환자실에 입원한 급성 신부전 환자에서 지속적 신대체요법", Kidney Research and Clinical Practice, 28(6), pp.559~569 (2009), 대한신장학회
- "Cancer statistic in Korea: Incidence, Mortality, Survival, and Prevalence in 2011" (2013)[URL]
- Kim JH., "Role of p53 in Gleevec response of chronic myeloid leukemic cells", 석사, pp.2006
- Cornet AD, "Sequential organ failure predicts mortality of patients with a haematological malignancy needing intensive care", European Journal of Hematology, 74(6), pp.511~516 (2005)
- Hampshire PA, "Admission factors associated with hospital mortality in patients with haematological malignancy admitted to UK adult, general critical care units: A secondary analysis of the ICNARC Case Mix Programme Database", Critical Care, 13(4), pp.R137~ (2009)[DOI]
- Geerse DA, "Prognosis of patients with haematological malignancies admitted to the intensive care unit : Sequential Organ Failure Assessment(SOFA)trend is a powerful predictor of mortality", European Journal of Internal Medicine, 22(1), pp.57~61 (2011)
- Yoo JY, "Mortality and Mortality factors of ICU admission patient after CPR.", The Korean Academy of Tuberculosis and Respiratory Diseases, pp.266~ (2012)
- Jacobe SJ, "Outcome of children requiring admission to an intensive care unit after bone marrow transplantation", Critical Care Medicine, 31(5), pp.1299~1305 (2003)