University of Tennessee Health Science Center, Memphis, TN 38103, United States.
Department of Pediatric Intensive Care, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, Netherlands.
Crit Rev Oncol Hematol. 2024 Nov;203:104467. doi: 10.1016/j.critrevonc.2024.104467. Epub 2024 Aug 9.
Pediatric oncology patients have increased risk for critical illness; outcomes are well described in high-income countries (HICs); however, data is limited for low- and middle-income countries (LMICs).
We systematically searched PubMed, EMBASE, Web of Science, CINAHL and Global Health databases for articles in 6 languages describing mortality in children with cancer admitted to intensive care units (ICUs) in LMICs. Two investigators independently assessed eligibility, data quality, and extracted data. We pooled ICU mortality estimates using random effect models.
Of 3641 studies identified, 22 studies were included, covering 4803 ICU admissions. Overall pooled mortality was 30.3 % [95 % Confidence-interval (CI) 21.7-40.6 %]. Mechanical ventilation [odds ratio (OR) 12.2, 95 %CI:6.2-24.0, p-value<0.001] and vasoactive infusions [OR 6.3 95 %CI:3.3-11.9, p-value<0.001] were associated with ICU mortality.
ICU mortality among pediatric oncology patients in LMICs is similar to that in HICs, however, this review likely underestimates true mortality due to underrepresentation of studies from low-income countries.
儿科肿瘤患者患重病的风险增加；高收入国家（HIC）对其预后有详细的描述；然而，中低收入国家（LMIC）的数据有限。
我们系统地检索了 PubMed、EMBASE、Web of Science、CINAHL 和 Global Health 数据库，以获取用 6 种语言描述中低收入国家儿童肿瘤患者入住重症监护病房（ICU）的死亡率的文章。两名调查员独立评估了合格性、数据质量，并提取了数据。我们使用随机效应模型汇总了 ICU 死亡率的估计值。
在 3641 项研究中，有 22 项研究被纳入，涵盖了 4803 例 ICU 入院病例。总体 ICU 死亡率为 30.3%[95%置信区间（CI）为 21.7%-40.6%]。机械通气[比值比（OR）12.2，95%CI：6.2-24.0，p<0.001]和血管活性药物输注[OR 6.3，95%CI：3.3-11.9，p<0.001]与 ICU 死亡率相关。
中低收入国家儿科肿瘤患者的 ICU 死亡率与 HIC 相似，但由于低收入国家的研究代表性不足，本综述可能低估了真实死亡率。
