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合并症指数作为实体瘤儿科患者死亡率的预测指标

Comorbidity Index as a Predictor of Mortality in Pediatric Patients With Solid Tumors.

作者信息

Torres-Espíndola Luz María, Demetrio-Ríos Joel, Carmona-Aparicio Liliana, Galván-Díaz César, Pérez-García Martín, Chávez-Pacheco Juan Luís, Granados-Montiel Julio, Torres-Ramírez de Arellano Israel, Aquino-Gálvez Arnoldo, Castillejos-López Manuel De Jesús

机构信息

Pharmacology Laboratory, National Institute of Pediatrics, Mexico City, Mexico.

Neuroscience Laboratory, National Institute of Pediatrics, Mexico City, Mexico.

出版信息

Front Pediatr. 2019 Mar 1;7:48. doi: 10.3389/fped.2019.00048. eCollection 2019.

Abstract

The objective of this study was to determine whether a comorbidity index could be used to predict mortality in pediatric patients with chemotherapy-treated solid tumors. Pediatric patients who underwent chemotherapy treatment for solid tumors were included, and demographic, clinical, and comorbidity data were obtained from patient electronic records. A total of 196 pediatric patients with embryonic solid tumors were included. Metastatic tumors were the most frequently observed ( = 103, 52.6%). The most common comorbidities encountered for the Charlson comorbidity index (CCI) were cellulitis ( = 24, 12.2%) and acute renal failure ( = 15, 7.7%). For the Pediatric Comorbidity Index (PCI), the most frequent comorbidities were pneumonia and sepsis, with = 64 (32.7%) for each. We evaluated established the prognostic values for both indexes using Kaplan-Meier curves, finding that the CCI and PCI could predict mortality with < 0.0001. Using the PCI, we observed 100% survival in patients without comorbidities, 70% survival in patients with a low degree of comorbidity, and 20% survival in patients with a high degree of comorbidity. Greater discrimination of probability of survival could be achieved using degrees of comorbidity on the PCI than using degrees of comorbidity on the CCI. The application of the PCI for assessing the hospitalized pediatric population may be of importance for improving clinical evaluation.

摘要

本研究的目的是确定合并症指数是否可用于预测接受化疗的实体瘤儿科患者的死亡率。纳入了接受实体瘤化疗治疗的儿科患者,并从患者电子记录中获取人口统计学、临床和合并症数据。共纳入196例患有胚胎性实体瘤的儿科患者。转移性肿瘤最为常见(n = 103,52.6%)。Charlson合并症指数(CCI)中最常见的合并症是蜂窝织炎(n = 24,12.2%)和急性肾衰竭(n = 15,7.7%)。对于儿科合并症指数(PCI),最常见的合并症是肺炎和败血症,每种情况均为n = 64(32.7%)。我们使用Kaplan-Meier曲线评估了这两个指数的预后价值,发现CCI和PCI均可预测死亡率,P < 0.0001。使用PCI,我们观察到无合并症患者的生存率为100%,合并症程度低的患者生存率为70%,合并症程度高的患者生存率为20%。与使用CCI的合并症程度相比,使用PCI的合并症程度对生存概率的区分度更高。PCI在评估住院儿科人群中的应用可能对改善临床评估具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afd1/6405632/b1f58028a97b/fped-07-00048-g0001.jpg

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