Hemophagocytic Lymphohistiocytosis in Intensive Care Unit A 71-Case Strobe-Compliant Retrospective Study

T. Barba , Delphine Maucort-Boulch (1, 2, 3) , J. Iwaz , J. Bohe , J. Ninet , A. Hot , J. C. Lega (4) , C. Guerin , Laurent Argaud , C. Broussolle , Y. Jamilloux , J. C. Richard , P. Seve

1 Biostatistiques santé
2 Service de Biostatistiques [Lyon]
3 HCL - Hospices Civils de Lyon
4 Evaluation et modélisation des effets thérapeutiques

Hemophagocytic lymphohistiocytosis (HLH) is a critical condition that may lead to organ failure and early death. The aim of this retrospective observational study was to describe a cohort of HLH patients admitted to intensive care unit (ICU) and investigate the risk factors of early death. A positive HLH diagnosis was defined by an HScore \textgreater= 169. Univariate and multivariate analyses were carried out to investigate hospital and 28-day mortality risk factors. Between January 2002 and July 2014, 71 HLH cases were seen at our institution. The overall 28-day mortality (start at ICU admission) and hospital mortality were 38% and 68%, respectively. The factors associated with increased 28-day mortality were the sequential organ failure assessment score at ICU admission (P \textless .001) and advance in age (P = 0.03). The factors associated with increased hospital mortality were a high sequential organ failure assessment score at ICU admission (P \textless 0.01), advance in age (P = 0.04), and the presence of lymphoma-related HLH or HLH of unknown origin (P \textless 0.01). Organ failure overtops the classical early-death risk factors in adult ICU-admitted HLH patients. This failure and the subsequent early death may be prevented by timely specific cytotoxic therapies and the control of the underlying disease.

Mots clés: General & Internal Medicine; dysfunction; infection; adult patients; spectrum; disease

Domaines: Sciences du Vivant [q-bio]

T. Barba, Delphine Maucort-Boulch, J. Iwaz, J. Bohe, J. Ninet, et al.. Hemophagocytic Lymphohistiocytosis in Intensive Care Unit A 71-Case Strobe-Compliant Retrospective Study. Medicine, 2015, 94 (51), pp.7. ⟨10.1097/md.0000000000002318⟩. ⟨hal-01850559⟩