Outcome and prognostic factors seen in pediatric oncology patients admitted in PICU of a developing country

Abstract

Objective: To evaluate the outcome and prognostic factors for oncology patients in the PICU of a tertiary care centre in a developing country.

Methods: A retrospective chart review was done to assess the outcome of children with cancer in the pediatric intensive care unit (PICU) of a developing country from January 2000 through December 2009. 74 medical records were reviewed for data regarding demographics, admitting diagnosis, Pediatric Risk of Mortality (PRISM) III score and the therapeutic modalities used.

Results: Of the 74 children admitted with mean age of 6.3 years (range 1-14); 53 were boys (71.6%) and 21 were girls (28.4%). Majority of the patients (37%) had hematological malignancy. The major indication for PICU admission was post-operative care (32%) followed by acute respiratory failure (24.3%), neurological complications (20.3%). The median PRISM III score was 7.0 (range 0-30). The overall mortality was 32.4% (24/74). The mean length of PICU stay was 6.3 days (ranging from 0-28 days). Seventy percent (52/74) of the children had multi organ failure (MOF). Mortality was significantly related to presence of multi-organ dysfunction syndrome and high PRISM III scores on admission and use of inotropic support with mechanical ventilation.

Conclusions: The mortality in children with cancer in PICU in the present study is comparable to previous reports and is related to higher PRISM III score, presence of multiorgan dysfunction syndrome and use of ICU therapies.