Prognostic factors in children requiring admission to an intensive care unit after hematopoietic stem cell transplant

• Published in: Hematological oncology 2004-03, Vol.22 (1), p.1-9
• Main Authors: Cheuk, Daniel Ka Leung, Ha, Shau Yin, Lee, So Lun, Chan, Godfrey Chi Fung, Tsoi, Nai Shun, Lau, Yu Lung
• Format: Article
• Language: English
• Subjects: Adolescent; Analysis of Variance; Cause of Death; Child; Child, Hospitalized; Child, Preschool; Critical Care - statistics & numerical data; Female; Humans; Infant; Intensive Care Units - utilization; Leukemia - surgery; Male; Neoplasms - surgery; Retrospective Studies; Stem Cell Transplantation - adverse effects; Stem Cell Transplantation - mortality; Transplantation, Autologous - statistics & numerical data; Transplantation, Homologous - statistics & numerical data
• ISSN: 0278-0232; 1099-1069
• DOI: 10.1002/hon.724

The objectives of this study are to identify prognostic factors of survival to discharge in pediatric hematopoietic stem cell transplant (HSCT) recipients requiring intensive care unit (ICU) admission, and to determine the utility of the Oncological Pediatric Risk of Mortality (O‐PRISM) in predicting death of these patients. A retrospective cohort of 125 pediatric HSCT recipients from October 1992 to September 2002 was analysed to evaluate risk factors of mortality in those admitted to ICU after HSCT. Nineteen patients (median age 7.8 years, 14 boys) required 24 ICU admissions post‐HSCT. The most frequent underlying diseases were acute myeloid leukemia (n=5). The survival rate on discharge from ICU was 54%. In univariate analysis, risk factors of mortality included earlier requirement of ICU admission post‐HSCT (median 34 versus 166 days, p=0.002), a longer delay before ICU admission (median 12 versus 5 h, p=0.02), lack of neutrophil (p=0.011) or platelet engraftment (p=0.008), macroscopic hemorrhage (p