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Functional outcomes at PICU discharge in hemato-oncology children at a tertiary oncology center in Hong Kong

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Abstract

Background

Advancements in cancer treatment have resulted in longer survival but often at the expense of new therapy-associated morbidities. The aim of this study is to evaluate functional outcomes of hemato-oncology patients at PICU discharge, and to identify associated risk factors.

Methods

A single-center retrospective observational study. All children (< 19 years) with a hemato-oncology diagnosis admitted to the Hong Kong Children’s Hospital PICU over a 2-year period were included. Functional status upon admission and discharge were compared. Univariable and multi-variable analyses were employed to identify risk factors associated with new morbidities.

Results

Out of 288 PICU admissions, there were 277 live discharges (mortality 4%), of which 52 (18.8%) developed new morbidities. Emergency admission, severity of illness at admission, organ dysfunction and support were associated with new morbidities (OR 1.08–11.96; p < 0.05). Adjusting for confounding factors, higher Pediatric Logistic Organ Dysfunction 2 score at admission was significantly associated with development of new morbidities (OR 1.34; 95% CI 1.18–1.54; p < 0.001).

Conclusion

Critically ill children with hemato-oncological diseases had a higher rate of developing new morbidities (18.8%) compared with the general PICU population (4–8%). This was associated with severity of illness at admission. Further work is warranted to understand the lasting effects of these new morbidities and mitigating interventions.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to individual privacy, but are available from the corresponding author upon reasonable request.

Abbreviations

CI:

Confidence interval

FiO2 :

Fraction of inspired oxygen

FSS:

Functional status scale

GCS:

Glasgow coma scale

IBM:

International Business Machines Corporation

ICU:

Intensive care unit

IQR:

Interquartile range

HFNC:

High flow nasal cannula

HKCH:

Hong Kong Children’s Hospital

PaO2 :

Partial pressure of oxygen

PELOD-2:

Pediatric logistic organ dysfunction 2

PICANet:

Paediatric intensive care audit network

PIM3:

Pediatric index of mortality 3

PICU:

Pediatric intensive care unit

SD:

Standard deviation

SPSS:

Statistical package for the social sciences

VIS:

Vasoactive-inotropic score

WBC:

White blood cells

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Authors and Affiliations

  1. Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China

    Karen K. Y. Leung & Kam Lun Hon

  2. Paediatric Intensive Care Unit, Great Ormond Street Hospital NHS Foundation Trust, London, UK

    Samiran Ray

  3. Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China

    Karen K. Y. Leung & Godfrey C. F. Chan

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  1. Karen K. Y. Leung
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  3. Godfrey C. F. Chan
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  4. Kam Lun Hon
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Contributions

KKYL, SR, KLH contributed to the concept and design, analysis, and interpretation of data. KKYL contributed to acquisition of data, writing the original draft. All authors contributed to revising it critically for important intellectual content and final approval of the version to be published.

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Correspondence to Karen K. Y. Leung.

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No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Ethical approval

This study was approved by the Hong Kong Children’s Hospital Research Ethics Committee (Reference number: HKCH-REC-2020–070).

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Cite this article

Leung, K.K.Y., Ray, S., Chan, G.C.F. et al. Functional outcomes at PICU discharge in hemato-oncology children at a tertiary oncology center in Hong Kong. Int J Clin Oncol 27, 1904–1915 (2022). https://doi.org/10.1007/s10147-022-02244-3

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  • DOI: https://doi.org/10.1007/s10147-022-02244-3

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