Outcome of oncology patients in the pediatric intensive care unit.
We evaluated the outcome of oncology patients in the Pediatric Intensive Care Unit (PICU) from a total of 72 consecutive admissions. Severity of illness and quantity of care were measured by the Physiologic Stability Index (PSI) and the Therapeutic Intervention Scoring System (TISS), respectively. The overall mortality was 51% and was especially high in patients admitted for acute organ system failure (OSF)-66%. Acute respiratory failure was the most frequent OSF (73%) and the most common cause for PICU admission. A poor outcome was associated with severe leucopenia (less than 1000 WBC/mm3, 91% mortality), acute renal failure (94% mortality) and central nervous system deterioration (83% mortality). When the outcome was predicted using a quantitative algorithm the observed mortality was significantly higher than the predicted for all admissions with a PSI higher than 5. Improved scoring systems are required to enable characterization of pediatric cancer patients admitted to the PICU.
Sivan
Y
Y
Pediatric Intensive Care Unit, Beilinson Medical Center, Petah Tikva, Israel.
Schwartz
P H
PH
Schonfeld
T
T
Cohen
I J
IJ
Newth
C J
CJ
D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality; D000293:Adolescent; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000592:standards*; D007902:Length of Stay; D007970:Leukopenia / Q000209:etiology / Q000401:mortality; D008495:Medical Oncology / Q000592:standards*; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D009369:Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000209:etiology; D012720:Severity of Illness Index; D015996:Survival Rate