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Comorbidity Index as a Predictor of Mortality in Pediatric Patients With Solid Tumors

Luz María Torres-Espíndola1, Joel Demetrio-Ríos1, Liliana Carmona-Aparicio2

  • 1Pharmacology Laboratory, National Institute of Pediatrics, Mexico City, Mexico.

Frontiers in Pediatrics
|March 19, 2019
PubMed

Insights

The Pediatric Comorbidity Index (PCI) effectively predicts mortality in children with solid tumors treated with chemotherapy. Higher comorbidity scores on the PCI correlate with lower survival rates, aiding clinical evaluation.

Area of Science:

  • Pediatric Oncology
  • Clinical Epidemiology

Background:

  • Comorbidity indices are crucial for assessing patient prognosis.
  • Predicting mortality in pediatric solid tumors requires validated tools.

Purpose of the Study:

  • To evaluate the predictive value of comorbidity indices for mortality in pediatric patients with solid tumors receiving chemotherapy.
  • To compare the prognostic performance of the Charlson Comorbidity Index (CCI) and the Pediatric Comorbidity Index (PCI).

Main Methods:

  • Retrospective analysis of 196 pediatric patients with solid tumors treated with chemotherapy.
  • Data collection included demographics, clinical information, and comorbidities from electronic health records.
  • Kaplan-Meier curves were used to assess the prognostic value of CCI and PCI.

Main Results:

  • Metastatic tumors were present in 52.6% of patients.
  • Pneumonia and sepsis were the most frequent comorbidities in the PCI (32.7% each).
  • Both CCI and PCI demonstrated significant prognostic value for mortality (p < 0.0001).

Conclusions:

  • The PCI showed superior discrimination in predicting survival based on comorbidity burden compared to the CCI.
  • Patients with no comorbidities had 100% survival, while those with high comorbidity had 20% survival using the PCI.
  • The PCI is a valuable tool for clinical evaluation and prognosis assessment in hospitalized pediatric oncology patients.

Keywords:
cancercharlson comorbidity indexchemotherapymortalitypediatricsolid tumor

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