Prognostic Factors that Lead to Poor Outcomes for Patients with Multiple Myeloma Admitted to the ICU

Predictors of poor diagnosis for patients with multiple myeloma (MM) admitted to the intensive care unit (ICU) include organ failure, infection, and advanced disease status, according to a study published in Hematology.

In this study, researchers assessed 126 patients with MM admitted to the ICU with data obtained from the Medical Information Mart for Intensive Care III database. In the population of interest, more than 29% died in the ICU. Logistic regression analysis was used to evaluate risk factors for ICU care and mortality.

The results showed that patients who died in the ICU had higher median blood urea nitrogen (57.0 vs. 29.0) and poorer Acute Physiology Scores (APS; 70.0 vs. 46.0) compared with surviving patients on the day of ICU admission. Also, in-ICU deceased patients had higher proportion of mechanical ventilation (64.7% vs. 26.6%) and vasopressor use (64.7% vs. 17.4%) at admission and positive pathogenic culture during ICU stay (58.8% vs. 19.3%). The researchers observed that APS and positive pathogenic culture were independent prognostic factors for ICU mortality, while risk factors for hospital mortality included higher APS and relapsed/refractory MM.

“The short-term prognoses for patients with MM admitted to the ICU were mainly determined by the severity of organ failure, infection, and disease status,” the researchers concluded.