A retrospective observational study on outcome of post-hematopoietic stem cell transplant patients needing intensive care unit admission

The use of hematopoietic stem cell transplant (HSCT) has become the standard of care for many types of hematologic malignancies. Unfortunately, HSCT is often associated with severe complications, including infection, respiratory failure from multiple etiologies, graft versus host disease, bleeding, sepsis, and multi-organ failure. These complications can occur acutely, especially during the period of neutropenia when patients are profoundly immunocompromised or at a later time after hospital discharge. Such complications often require admission to the intensive care unit (ICU) for higher level of care. The reported range of admission to the ICU is between 11% and 40% of all HSCT recipients. In addition to being medically complex and resource consuming, these patients have the additional stigma of dismal outcomes associated with ICU admission. Patients and methods In our tertiary care Oncology centre, we have a dedicated HSCT care unit where post-transplant patients are being cared until any significant deterioration happens and in the event of any such deterioration needing organ support, the patients get admitted in our intensive care unit (ICU). In this retrospective observational study we want to find the outcome of the HSCT patients coming to ICU primarily from the aspect of mortality and secondarily from the aspect of infection prevalence and associated factors like demography, type and duration of transplant, severity of organ support needed, etc. The study period was five years dating from 01/01/2018 to 31/12/2022. Results A total number of 41 post-HSCT patients got admitted to ICU during immediate and late post-transplant phase. They are being analyzed after retrieving data from the records and after obtaining hospital ethics committee permission. Among those only 8 patients could be survived and sent back successfully. However, one interesting finding was an improving (year-wise) trend in survival among these patients. Other important morbidity and mortality data analysis is ongoing. Conclusions There have been limited Indian data on outcome of HSCT patients getting admitted to ICU. Our aim is not only to analyse the outcome of these patients, but also to continue in future to find out any significant association and feasibility of any possible intervention measures.