Objective: Despite the developments in the diagnosis and treatment of cancer, malignancy remains one of the important causes of mortality in children. Aggressive chemotherapy leads to severeinfections or complicationsaffecting many systems, causing admissions to intensive care units (ICU). In our study, we aimed to evaluate the demographic data, clinical findings, and prognostic factors affecting hospitalization in the intensive care unit of the patients with hematological malignancy (HM) and solid organ malignancy (SOM).
Methodology: Between June 2013 and December 2018, patients were enrolled in our study between 28 and 18 years of with HM and SOM, who were hospitalized in the Pediatric Intensive Care of the University of Health Sciences Ankara Children's Hematology Oncology Training and Research Hospital. Demographic, clinical, laboratory, and treatment characteristics and survival in ICU were recorded.
Results: During the study period, 232 admissions of 158 patients with HM and SOM who were treated in ICU were evaluated. Patients diagnosed with acute lymphoblastic leukemia (ALL) and central nervous system (CNS) tumors were the most frequently hospitalized patients in the ICU, respectively. One hundred fifty-eight patients included in our study, 89 (56.3%) died. There was no statistically significant difference between HM and SOM patients in terms of mortality rate. The overall survival rate was calculated as 51.7%. Mortality was found to be higher in patients who need ICU admission while staying in the hospital, patients between the ages of 15–18, patients needed respiratory support before ICU and underwent mechanical ventilation (MV) during the first 24h of hospitalization, and patients needed inotropic support. Neutropenia, thrombocytopenia, hypoglycemia, hypoalbuminemia, and high levels of AST/ALT, urea, creatinine, total and direct bilirubin, LDH, and CRP values were associated with mortality. Detection of recurrenceor refractory disease and organ dysfunction is an independent risk factor on mortality.
Conclusion: One-year overall survival rate of our patients was 51.7%. Relapse/refractory disease and organ dysfunction were identified as two independent risk factors on mortality. Prospective, multicenter studies are needed to determine the increasing importance of factors in the follow-up of patients with hematological and solid organ malignancies and to determine long-term survival rates.
