Related Experiment Video
Updated: Oct 16, 2025
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Outcomes of Pediatric Oncology Patients Admitted to An Intensive Care Unit in a Resource-limited Setting
Shannon Cawood1, Mairi Bassingthwaighte2, Gita Naidu2
1Nelson Mandela Children's Hospital.
Insights
Pediatric oncology patients admitted to the pediatric intensive care unit (PICU) have higher mortality rates, especially with infections or need for vasoactive support. Early recognition and intervention are crucial for improving outcomes in these critically ill children.
Area of Science:
- Pediatric Oncology
- Critical Care Medicine
- Health Services Research
Background:
- Intensified treatment in pediatric oncology increases the need for intensive care.
- Resource-constrained settings face challenges in allocating critical care for pediatric oncology patients due to higher morbidity and mortality.
Purpose of the Study:
- To analyze the outcomes of pediatric oncology patients admitted to the pediatric intensive care unit (PICU).
- To identify factors associated with mortality in this patient population.
Main Methods:
- A 10-year retrospective review of pediatric oncology patients admitted to a single-center PICU.
- Multivariable analysis to determine independent predictors of PICU mortality.
Main Results:
- Pediatric oncology patients had a higher PICU mortality rate (18.8%) compared to the overall PICU population (10.5%).
- Infective indications for admission (RR=3.83) and need for vasoactive support (RR=7.50) were independently associated with increased PICU mortality.
Conclusions:
- Increased mortality in pediatric oncology patients is linked to sepsis, organ dysfunction, and organ support needs.
- Earlier recognition and intervention are vital for improving outcomes.
- Prospective studies are needed to optimize PICU referral and care for these children.
Background:
Improved survival and intensified treatment protocols in pediatric oncology have resulted in an increased need for intensive care. However, in resource-constrained settings, the higher morbidity and mortality of these patients raises sensitive issues around the optimal use of limited critical care resources.
Methods:
Single-center, 10-year retrospective review of pediatric oncology patients admitted to the pediatric intensive care unit (PICU).
Results:
Of the 117 admissions, 70.1% had solid tumors, 61.5% were admitted electively, and 76.1% were admitted for noninfective indications. PICU mortality of oncology patients was 18.8% relative to the PICU mortality of all patients in the same period of 10.5%. In a multivariable analysis, factors shown to be independently associated with PICU mortality were infective indications for admission (relative risk=3.83, confidence interval: 1.16; 12.6, P=0.028) and vasoactive support (relative risk=7.50, confidence interval: 1.72; 32.8, P=0.0074).
Conclusion:
The increased mortality associated with sepsis, organ dysfunction and need for organ support underscores the need for earlier recognition of and intervention in pediatric oncology patients requiring intensive care. Further prospective studies are needed to identify the most critical areas for improvement in the referral of these children to PICU, to optimize care and improve outcomes.
More Related Videos
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
01:30Pneumonia III: Complications and Assessment
01:22Acute Kidney Injury VI: Nursing Management
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:29Acute Kidney Injury III: Clinical Manifestations
01:22Acute Kidney Injury I: Introduction