G48. THE EFFECT OF CHANGING PROTOCOLS ON THE NEED FOR HIGH DEPENDENCY AND INTENSIVE CARE IN CHILDREN WITH CANCER: A REGIONAL REVIEW

L. Newbury, P. Sartori, R.I. Ross Russell.

Department of Paediatrics, Addenbrooke’s Hospital. Cambridge, CB2 2QQ

Introduction: Over the last few years there has been a trend towards more intensive treatment for paediatric oncology patients. This includes both primary and relapsed disease protocols. The impact of these changes on the usage of intensive care (PIC) and high dependency care (HD) is unclear.

Aim: To quantify the changes in PIC and HD usage for oncology patients over the last 3 years.

Methods: This hospital houses the only tertiary paediatric oncology unit as well as the only PIC unit for the region. We have reviewed the admissions to our combined PIC/HD unit over the last 3 years. The reason for admission, risk of mortality, length of stay and outcome were recorded.

Results: Annual admissions of Oncology patients to the unit increased from 32 in 1999 to 72 in 2001(2.2 fold increase). Bed days over this period increased from 61 to 302 (5 fold increase). The percentage of patients admitted for sepsis rose from 3% to 26%. Mortality on PICU remains quite low at 7% (standardised mortality rate against PIM, 1.04) but a further 5% of patients die within 1 month of discharge. Median length of stay has not changed (1 day for surgical and 2 days for medical patients) however a small number of long stay patients skew the data. In 2001 8 patients (11%) accounted for 59% of bed days.

Conclusion: Although many oncology children requiring HD continue to be nursed on a non HD ward, there is a substantial rise in admissions to our PIC unit. This probably reflects the increasing complexity of protocols and the rise in treatment of relapsed disease.

G49. INACCURACY OF MEASUREMENT OF GLOMERULAR FILTRATION RATE IN PATIENTS WITH LARGE SOLID TUMOURS

M. Burniston, S. Picton, U. Reid, M. Barnfield.

St James’s University Hospital, Leeds, West Yorkshire

Aims: Assessment of glomerular …