Risk factors for death in children and adolescents with cancer and sepsis/septic shock

Risk factors for death in children and adolescents with cancer and sepsis/septic shock

Author Silva, Elenice Domingos da Autor UNIFESP Google Scholar
Koch Nogueira, Paulo Cesar Autor UNIFESP Google Scholar
Russo Zamataro, Tania Maria Autor UNIFESP Google Scholar
Carvalho, Werther Brunow de Autor UNIFESP Google Scholar
Petrilli, Antonio Sergio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To assess risk factors for mortality in children and adolescents with cancer and sepsis/septic shock, admitted to intensive care unit.Patients and Methods: Retrospective Study of a cohort of cancer and sepsis/septic shock patients (n = 155) admitted to Oncological Pediatric Intensive Care Unit, between October 1998 and October 2001, with assessment of 12 potential risk factors for mortality by univariate analysis, followed by multivariable analysis.Results: Forty-seven out of 155 patients died (30.3%). In the present sample, after multivariable analysis, 3/12 variables proved to be statistically significant: respiratory infection [hazard ratio (HR) = 2.3 and 95% confidence interval (Cl) = 1.3-4.2], duration of granUlocytopenia (HR = 2.4 and 95% Cl = 1.2-4.9), and number of organ dysfunction (HR = 7.4 and 95% Cl = 2.6-21.3).Conclusions: Our data suggest that mortality in Oncological Pediatric Intensive Care Unit is high and the main factors involved in prognosis are number of dysfunctional organs, respiratory infections, and duration of granulocytopenia; the mortality rises 7.4 times for each dysfunctional organ. We believe that prospective and multicenter Studies are necessary to better characterize risk factors that are specific for cancer patients to produce a particular score to predict severity of complications and mortality of children with cancer.
Keywords mortality
critical care
Language English
Date 2008-07-01
Published in Journal Of Pediatric Hematology Oncology. Philadelphia: Lippincott Williams & Wilkins, v. 30, n. 7, p. 513-518, 2008.
ISSN 1077-4114 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 513-518
Origin http://dx.doi.org/10.1097/MPH.0b013e31815acae0
Access rights Closed access
Type Article
Web of Science ID WOS:000257591800005
URI http://repositorio.unifesp.br/11600/44550

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