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Critical illness epidemiology and mortality risk in pediatric oncology

Pravin Rr1,2, Enrica Ee Kar Tan2,3,4, Rehena Sultana5

  • 1Department of Pediatrics, KK Women's & Children's Hospital, Singapore.

Pediatric Blood & Cancer
|March 19, 2020
PubMed

Insights

Pediatric oncology patients in the pediatric intensive care unit (PICU) face high mortality risks. Emergency respiratory and neurology admissions, along with prior bacteremia, significantly increase this risk.

Area of Science:

  • Pediatric Intensive Care
  • Pediatric Oncology
  • Epidemiology

Background:

  • Patients with cancer admitted to the pediatric intensive care unit (PICU) have a high risk of mortality.
  • Understanding the specific risk factors for mortality in this vulnerable population is crucial for improving outcomes.

Purpose of the Study:

  • To describe the epidemiology of pediatric oncology patients admitted to the PICU.
  • To identify risk factors associated with mortality in this patient group.

Main Methods:

  • A retrospective cohort study analyzed consecutive PICU oncology admissions from 2011 to 2017.
  • Demographic and clinical data were compared between survivors and non-survivors.
  • Cox proportional hazard regression models assessed 60-day mortality risk, considering factors like the Pediatric Risk Of Mortality (PRISM) III score and previous bacteremia.

Main Results:

  • The study included 200 pediatric oncology patients with a median age of 7 years.
  • The overall 60-day mortality rate was 17.5% (35/200).
  • Independent risk factors for mortality included emergency admissions for respiratory (aHR: 5.62) and neurology (aHR: 6.96) conditions, and previous bacteremia (aHR: 3.37).

Conclusions:

  • Emergency respiratory and neurology admissions are significant risk factors for 60-day mortality in pediatric oncology PICU patients.
  • Previous bacteremia also independently increases the risk of mortality.
  • These findings highlight critical areas for intervention and monitoring in critically ill pediatric cancer patients.
Abstract

Keywords:
epidemiologyintensive caremortalityoncologypediatrics

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