Oncological pediatric early warning score: a dedicated tool to predict patient's clinical deterioration and need for pediatric intensive care treatment.

IF 1.2 4区 医学 Q4 HEMATOLOGY
Pediatric Hematology and Oncology Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI:10.1080/08880018.2024.2355543
Teresa Maccarana, Marta Pillon, Veronica Bertozzi, Elisa Carraro, Elena Cavallaro, Claudia Maria Bonardi, Luca Marchetto, Giulia Reggiani, Annalisa Tondo, Camilla Rosa, Rosanna Irene Comoretto, Angela Amigoni, Alessandra Biffi
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引用次数: 0

Abstract

Pediatric oncohematological patients frequently require PICU admission during their clinical history. The O-PEWS is a specific score developed to predict the need for PICU admission of oncohematological children. This study aimed at i) describing the trend of the O-PEWS in a cohort of patients hospitalized in the Pediatric Oncohematology ward and transferred to the PICU of Padua University Hospital, measured at different time-points in the 24 hours before PICU admission and to evaluate its association with mortality and presence of organ failure; ii) investigating the association between the recorded O-PEWS, and PIM3, number of organ failure and the need for ventilation, dialysis and inotropes.

This retrospective single-center study enrolled oncohematological children admitted to the PICU between 2017 and 2021. The O-PEWS, ranging between 0 and 15, was calculated on the available medical records and the TIPNet-Network database at 24 (T-24), 12 (T-12), 6 (T-6) and 0 (T0) hours before PICU admission.

RESULTS: 101 PICU admissions, related to 80 children, were registered. During the 24 hours prior to PICU admission, the O-PEWS progressively increased in all the patients. At T-24 the median O-PEWS was 3 (IQR 1-5), increasing to a median value of 6 (IQR 4-8) at T0. The O-PEWS was positively associated with mortality, organ failure and the need for ventilation at all the analyzed time-points and with the need for dialysis at T-6.

The O-PEWS appears as a useful tool for predicting early clinical deterioration in oncohematological patients and for anticipating the initiation of life-support treatments.

肿瘤儿科预警评分:预测患者临床病情恶化和儿科重症监护治疗需求的专用工具。
儿科血液病患者在临床病史中经常需要入住 PICU。O-PEWS是为预测儿童肿瘤患者是否需要入住PICU而开发的一种特殊评分。本研究旨在 i) 描述在帕多瓦大学医院儿科肿瘤病房住院并转入 PICU 的一组患者的 O-PEWS 变化趋势(在 PICU 入院前 24 小时内的不同时间点测量),并评估其与死亡率和器官衰竭的关联性;ii) 调查记录的 O-PEWS 与 PIM3、器官衰竭数量以及通气、透析和肌注需求之间的关联性。这项回顾性单中心研究纳入了2017年至2021年间入住PICU的患儿。根据现有病历和 TIPNet-Network 数据库计算了 PICU 入院前 24 小时(T-24)、12 小时(T-12)、6 小时(T-6)和 0 小时(T0)的 O-PEWS,范围在 0 至 15 之间。在进入 PICU 之前的 24 小时内,所有患者的 O-PEWS 都在逐渐增加。在 24 小时内,O-PEWS 的中位数为 3(IQR 1-5),在 24 小时后的第 0 小时,中位数增至 6(IQR 4-8)。在所有分析的时间点上,O-PEWS 都与死亡率、器官衰竭和通气需求呈正相关,在 T-6 时与透析需求呈正相关。
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来源期刊
CiteScore
2.60
自引率
5.90%
发文量
71
审稿时长
6-12 weeks
期刊介绍: PHO: Pediatric Hematology and Oncology covers all aspects of research and patient management within the area of blood disorders and malignant diseases of childhood. Our goal is to make PHO: Pediatric Hematology and Oncology the premier journal for the international community of clinicians and scientists who together aim to define optimal therapeutic strategies for children and young adults with cancer and blood disorders. The journal supports articles that address research in diverse clinical settings, exceptional case studies/series that add novel insights into pathogenesis and/or clinical care, and reviews highlighting discoveries and challenges emerging from consortia and conferences. Clinical studies as well as basic and translational research reports regarding cancer pathogenesis, genetics, molecular diagnostics, pharmacology, stem cells, molecular targeting, cellular and immune therapies and transplantation are of interest. Papers with a focus on supportive care, late effects and on related ethical, legal, psychological, social, cultural, or historical aspects of these fields are also appreciated. Reviews on important developments in the field are welcome. Articles from scientists and clinicians across the international community of Pediatric Hematology and Oncology are considered for publication. The journal is not dependent on or connected with any organization or society. All submissions undergo rigorous peer review prior to publication. Our Editorial Board includes experts in Pediatric Hematology and Oncology representing a wide range of academic and geographic diversity.
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