Comorbidity Index in Predicting Toxicity and Mortality Risk among patient Undergoing Hematopoietic Stem Cell Transplantation

Abstract

ABSTRACT: Despite current improvement in supportive care, mortality after hematopoietic stem cell transplantation remains high. Caring for patients undergoing hematopoietic stem cell transplantation is one of the most challenging in nursing subspecialities. Aim: Assess comorbidity index in predicting toxicity and mortality risk among patient undergoing hematopoietic stem cell transplantation through: assess comorbidities of patient’s pre-hematopoietic stem cell transplantation, assess toxicity and mortality risk post hematopoietic stem cell transplantation & assess the relation of pre-transplantation comorbidity scores and post transplantation-related toxicity and mortality in patients undergoing hematopoietic stem cell Transplantation. Study design: A descriptive retrospective design was utilized to conduct this study. Subject: A purposive sample of (44) patients undergoing allogeneic hematopoietic stem cell transplantation was recruited in this study. Setting: This study conducted at The Bone Marrow Transplantation Unit in Nasser institute for research and treatment. Tools: Tool I. Patient structured interview questionnaire, Tools II. The hematopoietic stem cell transplantation specific-comorbidity index (HCT-CI) & Tools III Seattle Criteria for Organ Toxicity after Bone Marrow Transplantation. Results: The study revealed that there was a positive correlation between comorbidity, organ toxicity and total mortality post bone marrow transplantation with p value 0.01. Conclusion: Comorbidity index is an important tool to predict toxicity and mortality rate among patient undergoing hematopoietic stem cell transplantation as there was a positive correlation between patient’s comorbidity (obesity, cerebrovascular disease, cardiac disease, infection, renal disease, prior malignancy, hepatic disease and psychiatric disorder) and total toxicity and mortality post bone marrow transplantation. Recommendations: Apply Comorbidity Index in predicting toxicity and mortality risk among patient undergoing Hematopoietic Stem Cell Transplantation.