Assessing Goals of Care in ICU with Short-Term and Long-Term Outcomes in Hematologic Malignancies

Intensive care admissions are common among patients with hematologic malignancy, and mortality is much higher in this group compared to the general cohort of ICU admissions. Predicting outcomes and making decisions on extent and intent of care remain a challenging task. Short-term outcomes depend on patient-related factors like age and comorbid illness, disease-related factors like grade and burden of malignancy and response to therapy, and critical illness severity predictors like APACHE II, SOFA score, and need for mechanical ventilation. Decision-making about ICU code of management would depend on the above factors and the oncological intent of therapy, it is palliative or curative, along with the patient’s wishes. Combined decision-making with open lines of communication between the intensivist and hematologist along with family meetings, would be vital in helping us make these decisions.