Severe Sepsis-Associated Morbidity and Mortality among Critically Ill Children with Cancer

Abstract

Severe sepsis (SS) in pediatric oncology patients is a leading cause of morbidity and mortality. We investigated the incidence of and risk factors for morbidity and mortality among children diagnosed with cancer from 2008 to 2012, and admitted with SS during the 3 years following cancer diagnosis. A total of 1,002 children with cancer were included, 8% of whom required pediatric intensive care unit (PICU) admission with SS. Death and/or multiple organ dysfunction syndrome occurred in 34 out of 99 PICU encounters (34%). Lactate level and history of stem-cell transplantation were significantly associated with the development of death and/or organ dysfunction (p < 0.05).

Outcome and Risk Factors of Febrile Episodes Treated with Broad Spectrum Antibiotics and Polyclonal IgM–Enriched Immunoglobulin in Pediatric Oncology Hematology Patients: A Retrospective Study

“…The 90-day mortality by sepsis-related organ failure and septic shock was 8.6% which is inferior to percentages reported in other studies. In a recent retrospective study, the mortality rate due to severe sepsis in pediatric oncohematological patients resulted 23%, 29 and previous studies reported mortality rates between 16 and 48%. 30 31 32…”

“…27,28 In this study, focused on patients considered at higher risk of severe infection complications and infectious death, the 90-day mortality by sepsis-related organ failure and septic shock was 8.6% that is inferior to percentages reported in other studies. In a recent retrospective study, the mortality rate due to severe sepsis in pediatric oncohematological patients resulted 23%, 29 and previous studies reported mortality rates between 16 and 48%. [30][31][32] The impact of the severity of infections on risk of death is confirmed by univariate analysis, where the factors significantly associated with 90-day mortality were the presence of hypotension, hypoxemia, localized-organ-infection signs, the admission to ICU, the administration of inotropes and the need for escalation of empiric antibiotic therapy.…”

Multimorbidity patterns and risk of hospitalisation in children: A population cohort study of 3.6 million children in England, with illustrative examples from childhood cancer survivors

“…These conditions could have arisen as a result of the primary cancer or metastatic disease, treatment toxicity or infection of skins, ocular and pulmonary function. 16 , 30 , 31 , 32 , 33 Others have shown that sepsis, fever and infection are potential complications in paediatric oncology patients 34 , 35 ; survivors may have impaired immune systems, 36 which increases the susceptibility to pathogens. Our results showed the risk remained elevated after five years after the initial cancer diagnosis.…”

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

“…Sepsis is a frequent cause of PICU admission and mortality for children affected with leukemia and, in general, severe hematologic diseases (10,11). In detail, Aljabari et al (12) still reported high rates of morbidity and mortality among this group of patients despite the improvements in supportive care and microbiological treatment: 8% of children develop severe sepsis requiring treatment in the PICU, and 34% of them die or develop multiple organ dysfunction syndrome. Therefore, additional strategies against sepsis should be sought.…”