title: Management of oncology patients admitted to the paediatric intensive care unit of a general children's hospital - a single center analysis.
abstract: BACKGROUND
  The improving prognosis of children with cancer has partially been attributed to the increasing importance of pediatric intensive care units (PICU). We analyze whether outcome of these patients on a PICU improved during the last decade and which factors may influence the outcome in our hospital.
  
  
  METHODS
  The charts of all oncology patients admitted to the PICU between 1998 and 2009 have been reviewed retrospectively. The survival of patients admitted for life threatening complications has been correlated with basic data, organ failure and the PRISM score. The results of 2 consecutive treatment periods (1998-2003 and 2004-2009) were compared.
  
  
  RESULTS
  644 admissions of 226 patients were recorded. 79 admissions were performed because of potentially life threatening complications (Group A), 236 for monitoring (B) and 329 admissions for interventions (C). 62% of Group A patients and all Group B and C patients were discharged alive. Poor outcome was associated with admission >28 days after initial diagnosis, PRISM >10, organ failure >2 organs, sepsis, allogeneic stem cell transplantation, need for mechanical ventilation or for catecholamines. The PICU survival rate of Group A patients admitted between 2004 and 2009 (78%) was higher than in the period between 1998 and 2003 (48%).
  
  
  CONCLUSIONS
  PICU provides essential services to support the pediatric oncology ward. Although children with cancer may have had benefit from advances in pediatric intensive care over the past decade, specific scoring systems for early identification of children with cancer needing PICU treatment are required. These systems might further improve PICU outcome in critical ill pediatric cancer patients.
authors.affiliation: Department of Pediatrics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany. roland.haase@medizin.uni-halle.de
authors.forename: R
authors.initials: R
authors.lastname: Haase
authors.forename: U
authors.initials: U
authors.lastname: Lieser
authors.forename: C
authors.initials: C
authors.lastname: Kramm
authors.forename: M
authors.initials: M
authors.lastname: Stiefel
authors.forename: C
authors.initials: C
authors.lastname: Vilser
authors.forename: T
authors.initials: T
authors.lastname: Bernig
authors.forename: N
authors.initials: N
authors.lastname: Merkel
authors.forename: C
authors.initials: C
authors.lastname: Mauz-Körholz
authors.forename: D
authors.initials: D
authors.lastname: Körholz
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000473:pathology / Q000628:therapy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D017052:Hospital Mortality; D006769:Hospitals, General / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000401:mortality / Q000628:therapy; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult