title: Prognostic factors and outcome of patients undergoing hematopoietic stem cell transplantation who are admitted to pediatric intensive care unit.
abstract: There are many studies about the prognosis and possible predictive factors of mortality for pediatric allogeneic hematopoietic stem cell transplantation (HSCT) recipients requiring pediatric intensive care unit (PICU) treatment, but the related study in China is lacking. This study investigates the data of these special patients in our center.
  
  
  
  This retrospective analysis is based on data from bone marrow center and PICU of our hospital. A total of 302 patients received allogeneic HSCT from January 2000 to December 2012, 29 of them were admitted to PICU because of various complications developed after transplantation. We collected the clinical data, identified the reasons why the patients to PICU, analyzed the mortality of these patients in PICU, and the prognostic factors of these patients.
  
  
  
  The main reasons for admission were: respiratory failure (62.07 %), neurological abnormities (13.79 %), renal failure (13.79 %) and others (10.35 %). Twenty-one cases (72.41 %) died. Compared with survivors, the deaths cases had lower pediatric critical illness score (77 vs. 88, p = 0.004); higher levels of lactic acid and serum urea nitrogen (4.02 vs. 1.19 mmol/L, P = 0.008;11.56 vs. 7.13 m moll /L, P = 0.045); more organs damaged (2.05 vs. 1.38, P = 0.01), and required more supportive treatments (1.52 vs. 0.63, P = 0.02). Univariate analysis identified pediatric critical illness score, use of mechanical ventilation, and the number of supportive treatment as the significant predictors to prognosis. Multivariate analysis by regression showed that pediatric critical illness score was the only independent prognostic factor (P = 0.035).
  
  
  
  In our study, pediatric allogeneic HSCT recipients who had PICU care had a high rate of mortality. Pediatric critical illness score was the independent prognostic factor for these patients.
authors.affiliation: Department of PICU, Shanghai Children's Medical Center, Pudong, Shanghai, China.
authors.forename: Kang
authors.initials: K
authors.lastname: An
authors.affiliation: Department of PICU, Shanghai Children's Medical Center, Pudong, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of PICU, Shanghai Children's Medical Center, Pudong, Shanghai, China.
authors.forename: Biru
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Hematology and Oncology, Shanghai Children's Medical Center, 1678 Dongfang Road, Pudong, Shanghai, China.
authors.forename: Changying
authors.initials: C
authors.lastname: Luo
authors.affiliation: Department of Hematology and Oncology, Shanghai Children's Medical Center, 1678 Dongfang Road, Pudong, Shanghai, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hematology and Oncology, Shanghai Children's Medical Center, 1678 Dongfang Road, Pudong, Shanghai, China.
authors.forename: Chengjuan
authors.initials: C
authors.lastname: Luo
authors.affiliation: Department of Hematology and Oncology, Shanghai Children's Medical Center, 1678 Dongfang Road, Pudong, Shanghai, China. chenjingscmc@hotmail.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China; D016638:Critical Illness; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014184:Transplantation, Homologous
keywords: Child; Hematopoietic stem cell transplantation; Pediatric intensive care unit; Prognosis