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Severe Sepsis-Associated Morbidity and Mortality among Critically Ill Children with Cancer
Salim Aljabari1, Alfred Balch2, Gitte Y Larsen1
1Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States.
Insights
Severe sepsis (SS) in pediatric oncology patients is a significant cause of death. This study identified lactate levels and stem-cell transplant history as key risk factors for death and organ dysfunction in these critically ill children.
Area of Science:
- Pediatric Oncology
- Critical Care Medicine
- Infectious Diseases
Background:
- Severe sepsis (SS) poses a major threat to pediatric cancer patients, contributing significantly to morbidity and mortality.
- Understanding risk factors is crucial for improving outcomes in this vulnerable population.
Purpose of the Study:
- To determine the incidence of severe sepsis in pediatric oncology patients.
- To identify risk factors associated with morbidity and mortality in these patients.
Main Methods:
- Retrospective analysis of 1,002 pediatric cancer patients diagnosed between 2008 and 2012.
- Examined patients admitted with severe sepsis during the 3 years post-cancer diagnosis.
- Assessed outcomes including death and multiple organ dysfunction syndrome (MODS).
Main Results:
- 8% of pediatric oncology patients required pediatric intensive care unit (PICU) admission for severe sepsis.
- 34% of PICU admissions for severe sepsis resulted in death and/or MODS.
- Elevated lactate levels and a history of stem-cell transplantation were significantly linked to adverse outcomes (p < 0.05).
Conclusions:
- Severe sepsis is a critical complication in pediatric oncology.
- Lactate levels and stem-cell transplantation history are significant predictors of mortality and organ dysfunction.
- Early identification and management of risk factors are essential for improving survival rates.
Abstract:
Severe sepsis (SS) in pediatric oncology patients is a leading cause of morbidity and mortality. We investigated the incidence of and risk factors for morbidity and mortality among children diagnosed with cancer from 2008 to 2012, and admitted with SS during the 3 years following cancer diagnosis. A total of 1,002 children with cancer were included, 8% of whom required pediatric intensive care unit (PICU) admission with SS. Death and/or multiple organ dysfunction syndrome occurred in 34 out of 99 PICU encounters (34%). Lactate level and history of stem-cell transplantation were significantly associated with the development of death and/or organ dysfunction ( p < 0.05).
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