OBJECTIVE: To assess risk factors for mortality in children and adolescents with cancer and sepsis/septic shock, admitted to intensive care unit. PATIENTS AND METHODS: Retrospective study of a cohort of cancer and sepsis/septic shock patients (n=155) admitted to Oncological Pediatric Intensive Care Unit, between October 1998 and October 2001, with assessment of 12 potential risk factors for mortality by univariate analysis, followed by multivariable analysis. RESULTS: Forty-seven out of 155 patients died (30.3%). In the present sample, after multivariable analysis, 3/12 variables proved to be statistically significant: respiratory infection [hazard ratio (HR)=2.3 and 95% confidence interval (CI)=1.3-4.2], duration of granulocytopenia (HR=2.4 and 95% CI=1.2-4.9), and number of organ dysfunction (HR=7.4 and 95% CI=2.6-21.3). CONCLUSIONS: Our data suggest that mortality in Oncological Pediatric Intensive Care Unit is high and the main factors involved in prognosis are number of dysfunctional organs, respiratory infections, and duration of granulocytopenia; the mortality rises 7.4 times for each dysfunctional organ. We believe that prospective and multicenter studies are necessary to better characterize risk factors that are specific for cancer patients to produce a particular score to predict severity of complications and mortality of children with cancer.
OBJECTIVE: To assess risk factors for mortality in children and adolescents with cancer and sepsis/septic shock, admitted to intensive care unit. PATIENTS AND METHODS: Retrospective study of a cohort of cancer and sepsis/septic shockpatients (n=155) admitted to Oncological Pediatric Intensive Care Unit, between October 1998 and October 2001, with assessment of 12 potential risk factors for mortality by univariate analysis, followed by multivariable analysis. RESULTS: Forty-seven out of 155 patients died (30.3%). In the present sample, after multivariable analysis, 3/12 variables proved to be statistically significant: respiratory infection [hazard ratio (HR)=2.3 and 95% confidence interval (CI)=1.3-4.2], duration of granulocytopenia (HR=2.4 and 95% CI=1.2-4.9), and number of organ dysfunction (HR=7.4 and 95% CI=2.6-21.3). CONCLUSIONS: Our data suggest that mortality in Oncological Pediatric Intensive Care Unit is high and the main factors involved in prognosis are number of dysfunctional organs, respiratory infections, and duration of granulocytopenia; the mortality rises 7.4 times for each dysfunctional organ. We believe that prospective and multicenter studies are necessary to better characterize risk factors that are specific for cancerpatients to produce a particular score to predict severity of complications and mortality of children with cancer.
Authors: Kusum Menon; Luregn J Schlapbach; Samuel Akech; Andrew Argent; Paolo Biban; Enitan D Carrol; Kathleen Chiotos; Mohammod Jobayer Chisti; Idris V R Evans; David P Inwald; Paul Ishimine; Niranjan Kissoon; Rakesh Lodha; Simon Nadel; Cláudio Flauzino Oliveira; Mark Peters; Benham Sadeghirad; Halden F Scott; Daniela C de Souza; Pierre Tissieres; R Scott Watson; Matthew O Wiens; James L Wynn; Jerry J Zimmerman; Lauren R Sorce Journal: Crit Care Med Date: 2022-01-01 Impact factor: 9.296