Should We Pay Attention to the Delay Before Admission to a Pediatric Intensive Care Unit for Children With Cancer? Impact on 1-Month Mortality. A Report From the French Children's Oncology Study Group, GOCE. Issue 5 (July 2017)

• Record Type: Journal Article
• Authors: Fausser, Jeanne-L.; Tavenard, Aude; Rialland, Fanny; Le Moine, Philippe; Minckes, Odile; Jourdain, Anne; Tirel, Olivier; Pellier, Isabelle; Gandemer, Virginie
• Is Part Of: Journal of pediatric hematology/oncology. Volume 39:Issue 5(2017)
• Publication Date: 2017-07
• Subjects: time delay -- cancer -- children -- pediatric intensive care -- mortality -- complications; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000000816
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Acute complications requiring admission to pediatric intensive care unit (PICU) are frequent for children with cancer. Our objective was to determine early prognostic factors of mortality in a cohort of children with cancer hospitalized in PICU for acute complications and particularly to assess whether the delay before admission to a PICU is an early predictor of mortality. We conduct a retrospective multicenter analysis. All patients transferred in PICU for acute complications between January 2002 and December 2012 were included. One-month mortality of the 224 patients analyzed was 24.5%. Delay before PICU admission was a significant prognostic factor of 1-month mortality with nonsurvivors experiencing a longer median delay than survivors (24 vs. 12 h, respectively, P <0.05). Time from diagnosis to PICU admission ( P <0.001), hematopoietic stem cell transplant ( P <0.05), the duration of neutropenia ( P <0.01), infection type ( P <0.001), number of organ dysfunctions ( P <0.001), and reaching any grade 4 toxicity before PICU admission ( P <0.001) also affected mortality rate at 1-month post-PICU discharge. In the multivariate analysis, only reaching any grade 4 toxicity before PICU admission influenced 1-month mortality (odds ratio, 2.30; 95% confidence interval, 1.07-4.96; P <0.05). These results suggest that PICU admission before severe impairment leads to a better outcome for children with cancer. Abstract : Supplemental Digital Content is available in the text.