Paediatric oncology patients form a significant proportion of patients admitted to PICU. We studied the short and long term survival of oncology patients admitted to a tertiary PICU.
Aim To evaluate the short-term and long -term survival of children admitted to PICU with cancer related problems and the impact of clinical variables on survival.
Methods Retrospective analysis of the PICANet data and case records of all oncology patients aged less than 16 years admitted to a tertiary PICU during a 5-year period from 2004 to 2008.
Results A total of 93 patients were identified, 90% survived to discharge from PICU of which 58% survived to 5 years.
64 patients were admitted for post-operative care and 29 for medical reasons. All patients in the post-operative group survived PICU discharge while only 20 patients survived in the medical group; post-discharge mortality at 3 months, 2 years and 5 years was 5, 12, and 3, and 5, 5, and 0 respectively.
Twenty patients received mechanical ventilation of which 7 survived; 13 received vasoactive drugs, of which 3 patients survived; 2 received renal replacement therapy but both died.
Nine patients had CNS complications (seizure/raised intracranial pressure), 2 died in PICU and 4 within 3 months of discharge.
Among PICU survivors the duration of stay was one day in 72%; only 3 (5%) received support for more than one organ system.
Among children who died on PICU, 6 died within 24 h; 7 (18%) received support for more than one organ system.
Fifty eight per cent of patients with CNS tumours survived to 5 years. Only 37% of patients admitted with haematological malignancies survived to 5 years.
Conclusions PICU survival for patients admitted solely for post-operative care was better than those with medical complications.
Better survival was associated with fewer days in PICU and fewer organs supported.
The type of malignancy also had a significant impact on both short and long term survival after PICU admission.
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