Indications for admission and prognostic factors in pediatric oncology patients admitted to the pediatric intensive care unit

Aim: In our study, it was aimed to investigate the reasons for hospitalization, developing organ dysfunctions, supportive treatments, mortality rates and prognostic factors of cases diagnosed with malignant disease and admitted to intensive care unit in Ankara University Faculty of Medicine, Department of Pediatrics, Oncology Department. Materials and Methods: In our study, electronic records and files of the cases diagnosed with malignant disease and admitted to intensive care unit between 2010-2020 in Ankara University Faculty of Medicine, Department of Pediatrics, Oncology Department were retrospectively analyzed. Results: 63 patients diagnosed with malignant disease and admitted to intensive care unit during their follow-up in Ankara University Faculty of Medicine, Department of Pediatrics, Oncology Department and 85 applications of these patients were included to our study. 53 of the applicants were male (%62.4). Considering the primary malignancy diagnoses of patients admitted to pediatric intensive care unit (PICU), hematological malignancies (n:38; %44.7) are the most common. Bone marrow transplantation performed patients were %14.1 (n:12) of the admissions. The disease stage with highly requirement for PICU is the progression/relapse phase with 49 admissions (%57.6). Admission to PICU mostly occured as a result of deterioration of inpatients condition. Fifty out of 85 pediatric oncology admissions to the PICU resulted in exitus. Overall mortality is %58.8. Cardiac and respiratory failure is the most common reason of PICU admission (n:24; %28.2 ve n:24; %28.2). Respiratory dysfunction was the most common organ dysfunction in PICU follow-up with 69 admissions (%81.2). All organ dysfunctions have a high mortality rate above %60. Ventilation was the most common supportive treatment in the PICU with 70 admissions (%82.4). All supportive treatments have a high mortality rate above %70. Conclusion: Cancer remains a major cause of death for children. Survival rates have improved significantly, through improvements in the treatment of childhood cancers. Due to these improvements, the requirement for intensive care support in pediatric oncology patients is increasing everyday. The treatment of children with cancer in PICU is a very challenging process. Thus, it is necessary to have more information about pediatric oncology patients who need intensive care. More knowledge about intensive care support and outcomes in pediatric cancer patients could allow for better understanding of underlying mechanisms of organ dysfunction, defining indications for intensive care hospitalization, identifying risk factors for clinical deterioration, more timely administration of life saving therapies, more cost-effective delivery of care and utilization of PICU. Key words: oncology, child, intensive care unit, prognosis, mortality