Authors (including presenting author) :
Leung KKY(1), Ray S(2), Chan GCF(3), Hon KL(1)
Affiliation :
(1)Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, (2)Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom, (3)Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital
Introduction :
Advancements in cancer treatment have resulted in longer survival in haemato-oncology patients, often comes at the expense of therapy-associated new morbidities. Functional outcomes of these survivors can significantly impact their quality of life. The prevalence of morbidity in general PICU survivors at discharge is 4-8%.
Objectives :
The aim of this study is to evaluate functional outcomes of haemato-oncology patients at PICU discharge, and to identify risk factors associated with these outcomes.
Methodology :
This is a retrospective observational study of all children with a haemato-oncology diagnosis or undergoing haematopoietic stem cell transplantation who have been admitted to the Hong Kong Children’s Hospital PICU over a 2-year period. Functional status upon admission and discharge were evaluated by validated instruments and compared. Univariable and multi-variable analyses were employed to identify risk factors associated with the development of new morbidities.
Result & Outcome :
Results
Out of 288 PICU admissions, there were 277 live discharges, of which 52 (18.8%) developed new morbidities (Figure). Emergency admission, severity of illness at admission, organ dysfunction and support were all associated with new morbidities with univariable analysis. After adjusting for associated factors, higher Paediatric Logistic Organ Dysfunction 2 score at admission was significantly associated with development of new morbidities (p< 0.001).
Conclusions
Critically-ill children with haemato-oncological diseases had a higher rate of developing new morbidities compared with the general PICU population. This was significantly associated with severity of illness at admission. Further work is warranted to understand the lasting effects of these new morbidities and interventions that may mitigate them.
