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Pediatric Cancer Outcomes in an Intensive Care Unit in Pakistan

Gull Zareen Khan Sial1, Saadiya Javed Khan1

  • 1Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.

Journal of Global Oncology
|March 13, 2019
PubMed

Insights

Pediatric oncology patients in developing countries face higher intensive care unit (ICU) mortality. Mechanical ventilation and high PRISM III scores predict poor outcomes, guiding resource allocation for critically ill children with cancer.

Area of Science:

  • Pediatric Oncology
  • Critical Care Medicine
  • Global Health

Background:

  • Pediatric cancer is a significant cause of death in developing nations.
  • Intensive care unit (ICU) admissions for pediatric oncology patients are rising due to aggressive chemotherapy.
  • Resource limitations in developing countries necessitate careful selection of patients for ICU care.

Purpose of the Study:

  • To review institutional experience with pediatric cancer patients requiring ICU admission.
  • To identify factors influencing outcomes in this vulnerable population.
  • To inform resource allocation strategies in low- and middle-income countries.

Main Methods:

  • Retrospective chart review of pediatric oncology patients admitted to the ICU from December 2015 to June 2017.
  • Data collected included patient demographics, diagnosis, disease stage, Pediatric Risk of Mortality (PRISM III) score, and interventions.
  • Analysis focused on ICU survival and factors associated with mortality.

Main Results:

  • 59 pediatric oncology patients were reviewed; 36 boys (61%) and 23 girls (39%), median age 4 years.
  • Common ICU admission reasons were respiratory distress, sepsis, and circulatory collapse.
  • ICU survival was 57.6%; mortality was linked to mechanical ventilation, inotropic support, organ failure, and high PRISM III scores.

Conclusions:

  • Pediatric oncology patients in developing countries have higher ICU mortality rates.
  • Mechanical ventilation and high PRISM III scores are significant predictors of mortality.
  • PRISM III scoring can aid in identifying patients who would benefit from intensive care in resource-limited settings.
Abstract

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