{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:21:48Z","timestamp":1792844508267,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) recipients are still believed to be poor candidates for ICU management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We investigated outcomes and determinants of mortality in a large multicenter retrospective cohort of Allo-HSCT patients admitted between January 1, 2015, and December 31, 2020, to 14 French ICUs. The primary endpoint was 90-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>In total, 1,164 patients were admitted throughout the study period. At the time of ICU admission, 765 (66%) patients presented with multiple organ dysfunction, including acute respiratory failure in 40% (n\u2009=\u2009461). The median sepsis-related organ failure assessment score was 6 (interquartile range, 4\u20138). Invasive mechanical ventilation, renal replacement therapy, and vasopressors were required in 438 (38%), 221 (19%), and 468 (41%) patients, respectively. ICU mortality was 26% (302 deaths). Ninety-day, 1-year, and 3-year mortality rates were 48%, 63%, and 70%, respectively. By multivariable analysis, age\u2009&amp;gt;\u200956 years (odds ratio [OR], 2.0 [95% confidence interval (CI), 1.53\u20132.60]; P\u2009&amp;lt;\u20090.001), time from Allo-HSCT to ICU admission between 30 and 90 days (OR, 1.68 [95% CI, 1.17\u20132.40]; P\u2009=\u20090.005), corticosteroid-refractory acute graft-versus-host disease (OR, 1.63 [95% CI, 1.38\u20131.93]; P\u2009&amp;lt;\u20090.001), need for vasopressors (OR, 1.9 [95% CI, 1.42\u20132.55]; P\u2009&amp;lt;\u20090.001), and mechanical ventilation (OR, 3.1 [95% CI, 2.29\u20134.18]; P\u2009&amp;lt;\u20090.001) were independently associated with 90-day mortality. In patients requiring mechanical ventilation, mortality rates ranged from 39% (no other risk factors for mortality) to 100% (four associated risk factors for mortality).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most critically ill Allo-HSCT recipients survive their ICU stays, including those requiring mechanical ventilation, with an overall 90-day survival rate reaching 51.8%. A careful assessment of goals of care is required in patients with two or more risk factors for mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202401-0135oc","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T12:37:56Z","timestamp":1721219876000},"page":"1017-1024","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":23,"title":["Outcomes in Critically Ill Allogeneic Hematopoietic Stem-Cell Transplantation Recipients"],"prefix":"10.1093","volume":"210","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2481-5728","authenticated-orcid":false,"given":"Antoine","family":"Lafarge","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Intensive et R\u00e9animation and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Dupont","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Intensive et 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