儿科瘤患者多器官功能障碍的预后因素 儿科重症监护病房的儿科瘤患者
Marijn Soeteman1, Marta F Fiocco1,2, Joppe Nijman3
1Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Frontiers in oncology
|July 28, 2023
概括
患有新发或进展性多器官功能障碍 (NPMOD) 的儿科重症监护病房 (PICU) 的儿科瘤患者面临更高的死亡率. NPMOD的主要风险因素包括血液瘤诊断,器官衰竭数和计划外入院.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 在瘤学瘤学.
- 关键护理医学 关键护理医学
背景情况:
- 儿童瘤病患入院于PICU的结果比非癌症患者差.
- 多器官功能障碍 (MOD) 显著影响PICU中的死亡率和发病率.
- 这种脆弱人群中MOD的风险因素在很大程度上仍未确定.
研究的目的:
- 确定在PICU入院时存在的风险因素,这些风险因素可以预测在PICU入院的第一周内出现新的或渐进的多器官功能障碍 (NPMOD).
- 在儿科瘤患者中分析基线共变量和NPMOD之间的关联.
- 为高风险患者提供早期干预和更密切的监测策略.
主要方法:
- 在2018年6月至2021年6月期间入院PICU的儿科瘤患者 (0-18岁) 的回顾性队列研究.
- 使用PODIUM标准来定义多器官功能障碍.
- 采用多变量后勤回归来识别NPMOD的风险因素,并通过引导程序进行内部验证.
主要成果:
- 包括761个PICU入院;20% (154个入院) 开发了NPMOD.
- 与没有NPMOD (1.0%) 的患者相比,NPMOD患者的死亡率显著更高 (14%).
- 独立的NPMOD风险因素包括血液瘤诊断,缺陷器官数量和计划外的PICU入院.
结论:
- 确定了NPMOD在PICU入院的关键风险因素,有助于儿童瘤患者的早期检测和干预.
- 在这个特定的患者群体中,PODIUM标准显示了改进的潜力,因此需要进一步验证.
- 研究结果支持加强对患有NPMOD风险的儿科瘤患者的监测和及时干预.
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