Prognostic Factors and Clinical Outcomes in Critically Ill Patients with Hematological Malignancies in the Intensive Care Unit

Background/Objectives: Patients with hematologic malignancies represent a high-risk population requiring intensive care due to infections, organ failure, and treatment-related complications. Despite advances in oncologic therapies and intensive care management, mortality remains high. This study aimed to evaluate prognostic factors and clinical outcomes in critically ill patients with hematologic malignancies admitted to the intensive care unit (ICU). Methods: Adult patients (≥18 years) with hematologic malignancies who were admitted to a medical ICU and stayed for at least 48 h were retrospectively included. Demographic characteristics, laboratory parameters, and APACHE II, SOFA, EASIX, and HALP scores, as well as mortality and organ support requirements, were evaluated. Results: A total of 108 patients were included. The median age was 61 years (IQR: 49–70), and 61% were male. The 28-day mortality was 64.8%. Overall, 83.3% of patients required invasive mechanical ventilation for at least 24 h. The median ICU length of stay was 5 days (IQR: 3–10). Median APACHE II and SOFA scores were 22 (IQR: 16–28) and 9 (IQR: 6–11), respectively. In multivariate analysis, SOFA score (OR: 1.218, 95% CI: 1.022–1.451) and the highest BUN level during ICU stay (OR: 1.034, 95% CI: 1.008–1.060) were independently associated with intubation. Admission creatinine level was the only independent predictor of renal replacement therapy (OR: 1.948, 95% CI: 1.081–3.510). APACHE II score was the only variable independently associated with 28-day mortality (OR: 1.064, 95% CI: 1.002–1.129). Conclusions: APACHE II showed a modest but statistically significant association with 28-day mortality in this cohort. Intubation and RRT requirements were mainly associated with organ dysfunction severity and renal impairment. Larger multicenter studies are needed to validate these findings and to better define risk stratification in critically ill hematologic patients.