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The Indian Journal of Pediatrics

, Volume 78, Issue 8, pp 969–972 | Cite as

Outcome and Prognostic Factors Seen in Pediatric Oncology Patients Admitted in PICU of a Developing Country

  • Nida Akhtar
  • Zehra Fadoo
  • Sukaina Panju
  • Anwarul HaqueEmail author
Original Article

Abstract

Objective

To evaluate the outcome and prognostic factors for oncology patients in the PICU of a tertiary care centre in a developing country.

Methods

A retrospective chart review was done to assess the outcome of children with cancer in the pediatric intensive care unit (PICU) of a developing country from January 2000 through December 2009. 74 medical records were reviewed for data regarding demographics, admitting diagnosis, Pediatric Risk of Mortality (PRISM) III score and the therapeutic modalities used.

Results

Of the 74 children admitted with mean age of 6.3 years (range 1–14); 53 were boys (71.6%) and 21 were girls (28.4%). Majority of the patients (37%) had hematological malignancy. The major indication for PICU admission was post-operative care (32%) followed by acute respiratory failure (24.3%), neurological complications (20.3%). The median PRISM III score was 7.0 (range 0–30). The overall mortality was 32.4% (24/74). The mean length of PICU stay was 6.3 days (ranging from 0–28 days). Seventy percent (52/74) of the children had multi organ failure (MOF). Mortality was significantly related to presence of multi-organ dysfunction syndrome and high PRISM III scores on admission and use of inotropic support with mechanical ventilation.

Conclusions

The mortality in children with cancer in PICU in the present study is comparable to previous reports and is related to higher PRISM III score, presence of multiorgan dysfunction syndrome and use of ICU therapies.

Keywords

Oncology PICU Outcome 

Notes

Conflict of Interest

None.

Role of Funding Source

None.

References

  1. 1.
    Meyer S, Gottschling S, Biran T, et al. Assessing the risk of mortality in pediatric intensive care unit: a novel risk score? Eur J Pediatr. 2005;164:563–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Diaz de Heredia C, Moreno A, Olive T, et al. Role of intensive care unit in children undergoing bone marrow transplantation with life threatening complications. Bone Marrow Transplant. 1999;24:163–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Gutierrez Y, Lamelas R, de Camerago B. Improved outcome of children with malignancy admitted to a pediatric intensive care. Crit Care Med. 2001;29:1292.CrossRefGoogle Scholar
  4. 4.
    Haase R, Mathony U, Lieser U, et al. Oncology patients on a pediatric intensive care unit—a 7-year experience. Klin Pediatri. 2003;215:234–40.CrossRefGoogle Scholar
  5. 5.
    Heying R, Schneider DT, Korholz D, et al. Efficacy and outcome of intensive care in pediatric oncology patients. Crit Care Med. 2001;29:2276–80.PubMedCrossRefGoogle Scholar
  6. 6.
    Keengwe IN, Stansfield F, Eden O, et al. Pediatric oncology and intensive care treatments: chaanging trends. Arch Dis Child. 1999;80:553–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Ben Abraham R, Toren A, Ono N, et al. Predictors of outcome in pediatric intensive care units of children with malignancies. J Pediatric Haematol Oncol. 2002;24:23–6.CrossRefGoogle Scholar
  8. 8.
    Butt W, Barker G, Walker C, et al. Outcome of children with hematological malignancy who are admitted to intensive care unit. Crit Care Med. 1988;16:761–4.PubMedCrossRefGoogle Scholar
  9. 9.
    Hallahan AR, Shaw PJ, Rowell G, et al. Improved outcomes of children with malignancy admitted to a pediatric intensive care unit. Crit Care Med. 2002;28:3718–21.CrossRefGoogle Scholar
  10. 10.
    Sivan Y, Schwartz PH, Schonfeld T, et al. Outcome of oncology patients in the pediatric intensive care unit. Intens Care Med. 1991;17:11–5.CrossRefGoogle Scholar
  11. 11.
    Dalton HJ, Slonim AD, Pollack MM. Multicentre outcome of pediatric oncology patients requiring intensive care. Pediatric Hematol Oncol. 2003;20:643–9.Google Scholar
  12. 12.
    Schneider DT, Lemberg P, Sprock I, et al. Introduction of the oncological pediatric risk of mortality score (O-PRISM) for ICU support following stem cell transplantation in children. Bone Marrow Transplant. 2000;25:1076–86.CrossRefGoogle Scholar
  13. 13.
    Van Veen A, Karstens A, van der Hoek AC, et al. The prognosis of oncological patients in the pediatric intensive care unit. Intens Care Med. 1996;22:237–41.CrossRefGoogle Scholar
  14. 14.
    Pollack MM, Patel KM, Ruttimann UE. PRISM III: an updated Pediatric Risk of Mortality score. Crit Care Med. 1996;24:743–52.PubMedCrossRefGoogle Scholar
  15. 15.
    Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6:2–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Dursun O, Hazar V, Karasu GT, et al. Prognostic factors of pediatric cancer patients admitted to the pediatric intensive care unit. J Ped Hematol Oncol. 2009;31:481–4.CrossRefGoogle Scholar
  17. 17.
    Fiser RT, West NK, Bush AJ, et al. Outcomes of severe sepsis in pediatric oncology patients. Pediat Crit Care Med. 2005;6:531–6.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2011

Authors and Affiliations

  • Nida Akhtar
    • 1
  • Zehra Fadoo
    • 1
  • Sukaina Panju
    • 1
  • Anwarul Haque
    • 1
    Email author
  1. 1.Department of Pediatrics and Child HealthAga Khan University HospitalKarachiPakistan

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