title: Impact of oral mucositis on short-term clinical outcomes in paediatric and adolescent patients undergoing chemotherapy.
abstract: OBJECTIVE
  The purpose of this study is to determine the burden of the peak severity of oral mucositis and severity over time on selected clinical outcomes in paediatric and adolescent patients receiving chemotherapy.
  
  
  METHODS
  A multicentre study enrolled 140 patients between the ages of 6 and 18 years, who had been treated with chemotherapy and completed the self-report Mouth and Throat Soreness-related questions of the Oral Mucositis Daily Questionnaire for 14 days. Clinical data were collected from patients' medical records during the first 14 days after starting chemotherapy.
  
  
  RESULTS
  Forty-one percent developed oral mucositis. Multiple linear regression analysis revealed that oral mucositis was significantly associated with an increased loss of baseline body weight, after controlling for nausea/vomiting (β = 0.34, p = 0.002). Multiple logistic regression analysis showed that severe mucositis was significantly associated with a higher probability of fluid replacement, after controlling for nausea/vomiting (adjusted OR = 12.8; 95 % CI = 2.7-61.0; p = 0.001). In addition, severe mucositis was significantly associated with a higher probability of fever, after controlling for neutropoenia (adjusted OR = 5.4; 95 % CI = 1.8-15.4; p = 0.002). No difference was observed for oral or systemic infections among the subgroups. About 5 % of the patients with oral mucositis had delays in chemotherapy (≤ 7 days). None of the patients had dose modification or unplanned hospitalization due to oral mucositis. The associations of peak severity and overall oral mucositis with adverse clinical outcomes in paediatric and adolescent patients were equivalent.
  
  
  CONCLUSIONS
  Oral mucositis is associated with negative effects on clinical outcomes.
authors.affiliation: Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore. nurckfk@nus.edu.sg
authors.forename: Karis Kin Fong
authors.initials: KK
authors.lastname: Cheng
authors.forename: Vincent
authors.initials: V
authors.lastname: Lee
authors.forename: Chak Ho
authors.initials: CH
authors.lastname: Li
authors.forename: Hui Leung
authors.initials: HL
authors.lastname: Yuen
authors.forename: Wan Yim
authors.initials: WY
authors.lastname: Ip
authors.forename: Hong Gu
authors.initials: HG
authors.lastname: He
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D057566:Self Report; D012720:Severity of Illness Index; D013280:Stomatitis / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents