Epidemiology and Predictors of Hospital Outcomes of Critically Ill Pediatric Oncology Patients: A Retrospective Study
Shilpushp J Bhosale, Malini Joshi, Vijaya P Patil, Amol T Kothekar, Sheila Nainan Myatra, Jigeeshu V Divatia, Atul P Kulkarni
Critical care oncology, Hematooncology, Hospital mortality, ICU mortality, ICU outcomes, Intensive care in pediatric cancer, Pediatric cancers, Solid tumors
Citation Information :
Bhosale SJ, Joshi M, Patil VP, Kothekar AT, Myatra SN, Divatia JV, P Kulkarni A. Epidemiology and Predictors of Hospital Outcomes of Critically Ill Pediatric Oncology Patients: A Retrospective Study. Indian J Crit Care Med 2021; 25 (10):1181-1186.
Background: The number of pediatric oncology patients admitted to the intensive care unit (ICU) has increased, and their hospital outcomes are improving. Since scarce data are available about this patient population, we conducted this retrospective study to evaluate the epidemiology and predictors of hospital outcomes.
Methods: We included all children with cancers who were admitted to our ICU over 1 year. We excluded children admitted after elective surgery and those following bone marrow transplant. We collected data about demographics, admission diagnosis, type of malignancies, and ICU interventions. The primary outcome was the hospital outcome. The secondary outcomes were ICU length of stay (LOS), and ICU and hospital mortality. We analyzed the predictors of hospital outcome.
Results: Two hundred pediatric oncology patients were admitted from November 1, 2014 to October 30, 2015. Seventy-eight children had solid organ malignancies, and the rest had hematological malignancies. Hematooncology malignancy patients had significantly higher hospital mortality than those with solid organ malignancies. (61.5 vs 34.6%, p = 0.015). On multivariate regression analysis, mechanical ventilation [odds ratio (OR), 14.64; 95% confidence interval (CI): 1.23–165.05; p <0.030], inotropes (OR, 9.81; 95% CI: 1.222–78.66; p <0.032), and the presence of coagulopathy (OR, 3.86; 95% CI: 1.568–9.514; p <0.003) were independent predictors of hospital mortality.
Conclusion: In this retrospective cohort of 200 children with malignancies, we found that children with hematologic cancer had significantly higher hospital mortality as compared to those with solid tumors. The need for mechanical ventilation, use of inotrope infusion, and coagulopathy were independent predictors of mortality.
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