Sivan Y, Schwartz P H, Schonfeld T, Cohen I J, Newth C J
Pediatric Intensive Care Unit, Beilinson Medical Center, Petah Tikva, Israel.
Intensive Care Med. 1991;17(1):11-5. doi: 10.1007/BF01708402.
We evaluated the outcome of oncology patients in the Pediatric Intensive Care Unit (PICU) from a total of 72 consecutive admissions. Severity of illness and quantity of care were measured by the Physiologic Stability Index (PSI) and the Therapeutic Intervention Scoring System (TISS), respectively. The overall mortality was 51% and was especially high in patients admitted for acute organ system failure (OSF)-66%. Acute respiratory failure was the most frequent OSF (73%) and the most common cause for PICU admission. A poor outcome was associated with severe leucopenia (less than 1000 WBC/mm3, 91% mortality), acute renal failure (94% mortality) and central nervous system deterioration (83% mortality). When the outcome was predicted using a quantitative algorithm the observed mortality was significantly higher than the predicted for all admissions with a PSI higher than 5. Improved scoring systems are required to enable characterization of pediatric cancer patients admitted to the PICU.
我们评估了儿科重症监护病房(PICU)中72例连续入院的肿瘤患者的治疗结果。疾病严重程度和护理量分别通过生理稳定性指数(PSI)和治疗干预评分系统(TISS)来衡量。总体死亡率为51%,因急性器官系统衰竭(OSF)入院的患者死亡率尤其高,为66%。急性呼吸衰竭是最常见的OSF(73%),也是PICU入院的最常见原因。预后不良与严重白细胞减少(白细胞计数低于1000/mm³,死亡率91%)、急性肾衰竭(死亡率94%)和中枢神经系统恶化(死亡率83%)相关。当使用定量算法预测结果时,对于所有PSI高于5的入院患者,观察到的死亡率显著高于预测值。需要改进评分系统,以便对入住PICU的儿科癌症患者进行特征描述。