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Factors affecting survival in children requiring intensive care after hematopoietic stem cell transplantation. A retrospective single‐center study
Author(s) -
Szmit Zofia,
KośmiderŻurawska Magdalena,
Król Anna,
Łobos Monika,
MiśkiewiczBujna Justyna,
Zielińska Marzena,
Kałwak Krzysztof,
MielcarekSiedziuk Monika,
SalamonowiczBodzioch Małgorzata,
Frączkiewicz Jowita,
Ussowicz Marek,
OwocLempach Joanna,
Gorczyńska Ewa
Publication year - 2020
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13765
Subject(s) - medicine , hematopoietic stem cell transplantation , retrospective cohort study , incidence (geometry) , pediatrics , single center , survival rate , transplantation , hematology , physics , optics
Allo‐HSCT is associated with life‐threatening complications. Therefore, a considerable number of patients require admission to a PICU. We evaluated the incidence and outcome of PICU admissions after allo‐HSCT in children, along with the potential factors influencing PICU survival. A retrospective chart review of 668 children who underwent first allo‐HSCT in the Department of Pediatric Hematology/Oncology and BMT in Wrocław during years 2005‐2017, particularly focusing on patients admitted to the PICU within 1‐year post‐HSCT. Fifty‐eight (8.7%) patients required 64 admissions to the PICU. Twenty‐four (41.5%) were discharged, and 34 (58.6%) patients died. Among the discharged patients, 6‐month survival was 66.7%. Compared with survivors, death cases were more likely to have required MV (31/34; 91.2% vs. 16/24; 66.7% P = .049), received more aggressive cardiac support (17/34; 50% vs. 2/24; 8.3% P = .002), and had a lower ANC on the last day of their PICU stay ( P = .004). Five patients were successfully treated with NIV and survived longer than 6 months post‐discharge. The intensity of cardiac support and ANC on the last day of PICU treatment was independent factors influencing PICU survival. Children admitted to the PICU after allo‐HSCT have a high mortality rate. Mainly those who needed a more aggressive approach and had a lower ANC on the last day of treatment had a greater risk of death. While requiring MV is associated with decreased PICU survival, early implementation of NIV might be considered.