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- W2315679029 abstract "We were very interested to read the recent article by Drs Cuthbertson et al on behalf of the Scottish Intensive Care Society.1 Patients with haematological malignancy are often refused admission to intensive care units based on their presumed poor prognosis, especially those who require mechanical ventilation and renal support. This study, and other recent studies, show the continuing improvement in survival in patients with haematological malignancy requiring critical care. The mortality from patients undergoing mechanical ventilation was particularly encouraging at 59%. As the authors pointed out, their population also included patients admitted following incidental surgery, which may falsely improve their survival rates. In a recent five-year retrospective study at our institution (unpublished data) we found a 95% (19/20 patients) mortality rate in those patients who underwent invasive mechanical ventilation; none of our patients were admitted postoperatively. We also found that for patients who had respiratory failure and received non-invasive ventilation (NIV), mortality was only 37.5% (3/8 patients). Note that there were small numbers in both groups. However, it would have been interesting to have seen what effect NIV would have had to the overall mortality rate in the Scottish study. Although reported survival rates are improving, it appears most of the improvements are reported from large tertiary centres.2-4 Perhaps this is due to the larger throughput of patients. For example, Gordon et al 4 at St Bartholomew’s had 101 patients during their year of study, while in our unpublished study we had an average of 8 patients per year. In this Scottish study, there were a total of 714 patients in 26 centres over five years, an average of 5.49 patients per centre per year. Is this enough for each institution? As Lord Darzi said recently in his framework for action, he wishes “to develop fewer, more advanced and more specialised hospitals, with excellent outcomes.”5 Should we then, be treating these patients in specialist centres?" @default.
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- W2315679029 date "2008-10-01" @default.
- W2315679029 modified "2023-09-26" @default.
- W2315679029 title "Correspondence Regarding: The Outcome of Haematological Malignancy in Scottish ICUs" @default.
- W2315679029 cites W157235284 @default.
- W2315679029 cites W1978490147 @default.
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- W2315679029 doi "https://doi.org/10.1177/175114370800900327" @default.
- W2315679029 hasPublicationYear "2008" @default.
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