Prognostic factors for multi-organ dysfunction in pediatric oncology patients admitted to the pediatric intensive care unit

被引:3
|
作者
Soeteman, Marijn [1 ]
Fiocco, Marta F. [1 ,2 ]
Nijman, Joppe [3 ]
Bollen, Casper W. [3 ]
Marcelis, Maartje M. [1 ]
Kilsdonk, Ellen [1 ]
Nieuwenhuis, Edward E. S. [4 ]
Kappen, Teus H. [5 ]
Tissing, Wim J. E. [1 ,6 ]
Woesten-van Asperen, Roelie M. [3 ]
机构
[1] Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
[2] Leiden Univ, Math Inst, Leiden, Netherlands
[3] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Dept Pediat Intens Care, Utrecht, Netherlands
[4] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Dept Pediat, Utrecht, Netherlands
[5] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Dept Anesthesiol, Utrecht, Netherlands
[6] Univ Groningen, Univ Med Ctr Groningen, Dept Pediat Oncol, Groningen, Netherlands
来源
FRONTIERS IN ONCOLOGY | 2023年 / 13卷
关键词
pediatric oncology; intensive care unit; multi-organ dysfunction; critical care; prognosis; SEVERE SEPSIS; MORTALITY; CHILDREN; PREVALENCE; OUTCOMES; INTERVENTION; ADMISSION; UPDATE;
D O I
10.3389/fonc.2023.1192806
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundPediatric oncology patients who require admission to the pediatric intensive care unit (PICU) have worse outcomes compared to their non-cancer peers. Although multi-organ dysfunction (MOD) plays a pivotal role in PICU mortality and morbidity, risk factors for MOD have not yet been identified. We aimed to identify risk factors at PICU admission for new or progressive MOD (NPMOD) during the first week of PICU stay. MethodsThis retrospective cohort study included all pediatric oncology patients aged 0 to 18 years admitted to the PICU between June 2018 and June 2021. We used the recently published PODIUM criteria for defining multi-organ dysfunction and estimated the association between covariates at PICU baseline and the outcome NPMOD using a multivariable logistic regression model, with PICU admission as unit of study. To study the predictive performance, the model was internally validated by using bootstrap. ResultsA total of 761 PICU admissions of 571 patients were included. NPMOD was present in 154 PICU admissions (20%). Patients with NPMOD had a high mortality compared to patients without NPMOD, 14% and 1.0% respectively. Hemato-oncological diagnosis, number of failing organs and unplanned admission were independent risk factors for NPMOD. The prognostic model had an overall good discrimination and calibration. ConclusionThe risk factors at PICU admission for NPMOD may help to identify patients who may benefit from closer monitoring and early interventions. When applying the PODIUM criteria, we found some opportunities for fine-tuning these criteria for pediatric oncology patients, that need to be validated in future studies.
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页数:12
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