Barking Catharina T M M, Masjosthusmann Katja, Rellensmann Georg, Ehlert Karoline, Zöllner Stefan, Jocham Sophie, Kremer Almut, Potratz Jenny, Rieger-Fackeldey Esther, Groll Andreas H
Departments of Pediatric Hematology and Oncology.
General Pediatrics, University Children's Hospital Muenster.
J Pediatr Hematol Oncol. 2020 Oct;42(7):e583-e588. doi: 10.1097/MPH.0000000000001718.
Pediatric cancer treatment and hematopoietic stem cell transplantation (HSCT) carry considerable risks of morbidity. We conducted a single-center retrospective analysis of intensive care unit (ICU) admissions in unselected children and adolescents treated for cancer or undergoing HSCT. In a 10-year time period, 140 patients had 188 ICU admissions for a life-threatening condition. Main reasons for ICU admission were respiratory or cardiovascular insufficiency and sepsis. Mortality in the ICU was 19.1% and related to organ failure or acute complications in 77.8% and progress of the underlying malignancy in 22.2%. Mortality rates at 30, 100, and 365 days after discharge from the ICU were 24.5%, 30.9%, and 39.9%. Kaplan-Meier survival probabilities at 5 and 10 years were 46.4% and 39.8%, respectively. Multivariable analysis revealed the number of failed organ systems, the number of prior ICU stays, and days spent in the ICU as parameters independently associated with death. Taken together, the outcome of pediatric cancer and/or HSCT patients admitted to the ICU for life-threatening conditions was not as dismal as reported elsewhere. Most patients benefitted from ICU care, and survival was predominantly compromised by the evolution of complications.
儿童癌症治疗和造血干细胞移植（HSCT）具有相当高的发病风险。我们对未经挑选的接受癌症治疗或进行HSCT的儿童和青少年入住重症监护病房（ICU）的情况进行了单中心回顾性分析。在10年时间里，140名患者因危及生命的状况188次入住ICU。入住ICU的主要原因是呼吸或心血管功能不全以及败血症。ICU的死亡率为19.1%，其中77.8%与器官衰竭或急性并发症有关，22.2%与潜在恶性肿瘤进展有关。从ICU出院后30天、100天和365天的死亡率分别为24.5%、30.9%和39.9%。5年和10年的Kaplan-Meier生存概率分别为46.4%和39.8%。多变量分析显示，衰竭器官系统的数量、之前入住ICU的次数以及在ICU的住院天数是与死亡独立相关的参数。总体而言，因危及生命状况入住ICU的儿童癌症和/或HSCT患者的结局并不像其他地方报道的那样糟糕。大多数患者从ICU护理中受益，生存主要受到并发症进展的影响。
