Infection-related mortality in Hispanic and non-Hispanic children with cancer
| Autor: | Rochelle R. Smits-Seemann, Hongyan Li, Jacob C. Pettit, Anne C. Kirchhoff, Mark Fluchel |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Infections Rate ratio Article White People law.invention Cohort Studies Young Adult 03 medical and health sciences symbols.namesake 0302 clinical medicine law Neoplasms Internal medicine medicine Humans 030212 general & internal medicine Poisson regression Child Proportional Hazards Models Cause of death business.industry Hazard ratio Infant Hispanic or Latino Hematology Pediatric cancer Intensive care unit Confidence interval Oncology Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Cohort symbols Female business |
| Zdroj: | Pediatric Blood & Cancer. 64:e26502 |
| ISSN: | 1545-5009 |
| DOI: | 10.1002/pbc.26502 |
| Popis: | Background Hispanic children with cancer experience poorer survival than their White counterparts. Infection is a known cause of cancer-related mortality; however, little is known about the risk of infection-related death among Hispanic children with cancer. We examine the association of Hispanic ethnicity with infection-related mortality and life-threatening events among children with cancer. Procedure For a cohort of all pediatric cancer patients diagnosed from 1986 to 2012 and treated at a single tertiary care center, we obtained national death records to determine all-cause mortality and infection-related mortality, as well as intensive care unit (ICU) admissions as a surrogate for life-threatening events. Cox proportional hazard models assessed all-cause mortality and infection-related mortality using ethnicity as the main independent variable. ICU admission rates were modeled using a zero-inflated Poisson regression model. Models were adjusted for gender, diagnosis year, age, residential location, and diagnosis. Results Of 6,198 patients, 741 (12%) were Hispanic. Mean follow-up was 11 years (SD = 8.04). There were 1,205 deaths, with 193 attributable to infection. Differences in all-cause mortality between Hispanic and non-Hispanic patients did not reach significance (hazard ratio [HR] = 1.14, 95% confidence interval [CI]: 0.96–1.36). However, Hispanic patients were 68% (HR = 1.68, 95% CI: 1.16–2.43) more likely to have an infection-related cause of death. Hispanic ethnicity was statistically associated with a higher rate of ICU admissions (rate ratio = 1.32, 95% CI: 1.12–1.56). Conclusion Hispanic pediatric cancer patients were more likely to have an infection-related death and higher rates of ICU admissions than non-Hispanic patients. Infection may be an overlooked contributor to poorer outcomes among Hispanic patients. |
| Databáze: | OpenAIRE |
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