Risk Factors and Outcomes Related to Pediatric Intensive Care Unit Admission after Hematopoietic Stem Cell Transplantation: A Single-Center Experience
| Autor: | Angela Amigoni, Emiliana Campagnano, Manuela Tumino, Marta Pillon, Marta Nizzero, Andrea Pettenazzo, Chiara Mainardi, Annaelena Contin, Giuseppe Basso, Antonio Marzollo, Maria Paola Boaro, Elisa Carraro, Elisabetta Calore, Chiara Messina, Manuela Cattelan |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Critical Care Bone marrow transplantation Multiple Organ Failure medicine.medical_treatment Hematopoietic stem cell transplantation Single Center Disease-Free Survival 03 medical and health sciences Patient Admission 0302 clinical medicine Humans Medicine Pediatric intensive care unit Cumulative incidence Mortality Child Retrospective Studies Outcome Transplantation business.industry Septic shock Incidence Incidence (epidemiology) Infant Risk factors Hematology Allografts medicine.disease Shock Septic Survival Rate surgical procedures operative Respiratory failure Child Preschool 030220 oncology & carcinogenesis Female Respiratory Insufficiency business 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 23:1335-1341 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2017.04.016 |
| Popis: | To describe incidence, causes, and outcomes related to pediatric intensive care unit (PICU) admission for patients undergoing hematopoietic stem cell transplantation (HSCT), we investigated the risk factors predisposing to PICU admission and prognostic factors in terms of patient survival. From October 1998 to April 2015, 496 children and young adults (0 to 23 years) underwent transplantation in the HSCT unit. Among them, 70 (14.1%) were admitted to PICU. The 3-year cumulative incidence of PICU admission was 14.3%. The main causes of PICU admission were respiratory failure (36%), multiple organ failure (16%), and septic shock (13%). The overall 90-day cumulative probability of survival after PICU admission was 34.3% (95% confidence interval, 24.8% to 47.4%). In multivariate analysis, risk factors predisposing to PICU admission were allogeneic HSCT (versus autologous HSCT, P = .030) and second or third HSCT (P = .018). Characteristics significantly associated with mortality were mismatched HSCT (P = .011), relapse of underlying disease before PICU admission (P .001), acute respiratory distress syndrome at admission (P = .012), hepatic failure at admission (P = .021), and need for invasive ventilation during PICU course (P .001). Our data indicate which patients have a high risk for PICU admission after HSCT and for dismal outcomes after PICU stay. These findings may provide support for the clinical decision-making process on the opportunity of PICU admission for severely compromised patients after HSCT. |
| Databáze: | OpenAIRE |
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