Aim: Critically ill hematologic patients (CIHPs) represent a distinct population in the intensive care unit (ICU), characterized by complex pathophysiology and high mortality rates. Prognostic assessment in this group remains challenging. This study aimed to evaluate the utility of acute illness severity and organ dysfunction scores in predicting ICU outcomes in CIHPs.
Study Design: This retrospective, single-center study was conducted in a dedicated hematology ICU. The prognostic performance of commonly used acute illness severity and organ dysfunction scores (APACHE II, SAPS II, and SOFA) was evaluated in CIHPs. ICU mortality was assessed as the primary outcome. Additionally, early trajectories of these scores—particularly changes by ICU day 3—were analyzed for their association with prognosis.
Results: A total of 107 patients were included. The median age of the patients was 62 (range: 53–70), and 69 (64.5%) were male. The ICU mortality rate was 40.2%. The most frequent underlying diagnoses were multiple myeloma (31.8%) and non-Hodgkin lymphoma (20.6%). Respiratory failure (68.2%) and sepsis (54.2%) were the leading reasons for ICU admission. Non-survivors had significantly higher APACHE II, SAPS II, and SOFA scores on both day 1 and day 3. Furthermore, non-survivors demonstrated a significant increase in all three scores over the first three ICU days. Among these parameters, the day 3 SOFA score was the strongest independent predictor of ICU mortality (OR 2.042, 95% CI 1.407–2.962; p = 0.001), suggesting that early organ dysfunction and its progression during the ICU stay are critical determinants of ICU mortality.
Conclusions: Acute illness severity and organ dysfunction scores are valuable tools for predicting ICU outcomes in CIHPs. In particular, early SOFA score trajectories—especially the day 3 SOFA score—provide superior prognostic information and may support clinical decision-making in this high-risk population.