Risk factors for mortality and re-admission of children with hematological malignancies to the intensive care unit due to sepsis.

Abstract

Children with hematological malignancies, are often hospitalized in pediatric intensive care units (PICU) for sepsis with high mortality and re-admission rates. Risk factors for both are inconsistent. We reviewed data of 190 admissions of children with hematological malignancies to PICU for sepsis. Survival rate (SR) was 85%. Mortality risk factors were: non-complete remission (p < 0.01) and status post-stem cell transplantation (p = 0.02), and best predictors were inotropic drugs (p < 0.01), and Pediatric logistic organ dysfunction-2 (p < 0.01) scores. Patients with viremia had the lowest SR (50%, 0.001). One-quarter of the children were re-admitted due to sepsis, and risk factors were: High-risk (HR) hematological malignancy (p < 0.01) and lack of central venous line (CVL) removal (p < 0.01). Sepsis remains a major cause of death in children with hematological malignancies, and re-admissions are common. Our findings support the recommendation of removing CVL during sepsis and highlight those at the highest risk for sepsis to consider individualized anti-infectious prophylaxis.