Leading Cause of Death in Children with Cancer

A retrospective study suggests that the greatest direct cause of death in children with cancer admitted to the pediatric intensive care unit (PICU) is multi-organ failure. The study was published in the January 2002 issue of the Journal of Pediatric Hemtology/Oncology.

The researchers, led by Dr. Gideon Paret, of Chaim Sheba Medical Center (Tel Hashomer, Israel), looked at the records of 94 pediatric cancer patients admitted to the PICU from 1989-1999. The overall 30-day survival rate was found to be 66%. Children with respiratory failure showed the highest mortality rate, which was 40%. Children with neurologic deterioration and circulatory collapse also revealed high rates of mortality (31% and 33.3%, respectively).

According to the researchers, the total number of organ system failures was greater among the nonsurvivors. Those children who needed ventilatory or inotropic support had worse outcomes. The mortality rate among children with sepsis was 50%, compared to 24% among children without sepsis. Thirty-six patients (38%) developed sepsis in the PICU, while 17 (18%) were found to have sepsis on admission to the PICU. Sepsis was found to be highly associated with the development of multi-organ failure.

Dr. Paret and his colleagues conclude in the article that "Further refinement of reliable clinical predictors of survival will enable better triage of these children to the PICU for possible prevention of systemic complications and reduction of mortality rates.”




Related Links:
Journal of Pediatric Hematology