Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
Copyright © 2021 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: DHK, SJP, KNK, HK, HJI, WKJ. Formal analysis: DHK, WKJ, SJP. Methodology: DHK, WKJ, SJP, HJI. Data curation: DHK, EJH. Writing-original draft: DHK, WKJ. Writing-review & editing: SJP, WKJ.
Values are presented as mean±standard deviation or number (%).
PICU: pediatric intensive care unit; OPRISM-III: oncological pediatric risk of mortality-III; PRISM-III: pediatric risk of mortality-III; pSOFA: pediatric Sequential Organ Failure Assessment; CRP: C-reactive protein; BNP: B-type natriuretic peptide.
Variable | Total (n=131) | Survivor (n=102) | Non-survivor (n=29) | P-value |
---|---|---|---|---|
Male | 63 (48.1) | 50 (49) | 13 (44.8) | 0.690 |
Age at HSCT | 9.46 (3.14–14.79) | 9.54 (2.63–14.84) | 9.46 (3.26–15.42) | 0.939 |
Age at PICU admission | 11.00 (4.00–15.00) | 11.00 (4.00–25.00) | 9.00 (3.00–15.00) | 0.233 |
Length of PICU stay (day) | 16.94±27.43 | 19.54±30.34 | 7.79±7.87 | 0.041 |
Underlying hemato-oncologic disease | 0.731 | |||
Leukemia | 67 (51.1) | 53 (52) | 14 (48.3) | |
Lymphoma | 7 (5.3) | 6 (5.9) | 1 (3.4) | |
Non-malignant hematologic disease | 26 (19.8) | 21 (20.6) | 5 (17.2) | |
Solid tumor | 31 (23.7) | 22 (21.6) | 9 (31) | |
Types of donor | 0.160 | |||
HLA matched (related) | 9 (6.9) | 9 (8.8) | 2 (6.9) | |
HLA matched (unrelated) | 37 (28) | 31 (30.4) | 4 (13.8) | |
HLA mismatched (related) | 53 (40.4) | 35 (34.3) | 16 (55.2) | |
HLA mismatched (unrelated) | 5 (3.8) | 5 (4.9) | 0 | |
Autologous | 27 (20.6) | 20 (19.6) | 7 (24.1) | |
No. of HSCTs | 0.013 | |||
1 | 106 (80.9) | 88 (86.3) | 18 (62.1) | |
≥2 | 25 (19.1) | 14 (13.7) | 11 (37.9) | |
Day from HSCT to admission | 0.064 | |||
<30 | 21 (16.0) | 14 (13.7) | 7 (24.1) | |
31–99 | 23 (17.6) | 15 (14.7) | 8 (27.6) | |
>100 | 87 (66.4) | 73 (71.6) | 14 (48.3) | |
Main reason for PICU admission | 0.460 | |||
Respiratory failure | 58 (44.3) | 45 (44.1) | 13 (44.8) | |
Neurologic defect | 18 (13.7) | 12 (11.8) | 6 (20.7) | |
Sepsis | 17 (13.0) | 13 (12.7) | 4 (13.8) | |
Renal failure | 12 (9.2) | 10 (9.8) | 2 (6.9) | |
Hemato-oncology complication | 12 (9.2) | 10 (9.8) | 2 (6.9) | |
Cardiovascular disease | 7 (5.3) | 7 (6.9) | 0 | |
Gastro-intestinal disease | 7 (5.3) | 5 (4.9) | 2 (6.9) | |
CMV infection | 35 (26.7) | 29 (28.4) | 6 (20.7) | 0.406 |
Veno-occlusive disease | 9 (6.9) | 7 (6.9) | 2 (6.9) | 0.995 |
Graft-versus-host disease | 28 (21) | 18 (17.6) | 10 (34.5) | 0.135 |
TA-TMA | 13 (9.9) | 11 (10.8) | 2 (6.9) | 0.537 |
Septic shock | 17 (13.0) | 13 (12.7) | 4 (13.8) | 0.022 |
Variable | Total (n=131) | Survivor (n=102) | Non-survivor (n=29) | P-value |
---|---|---|---|---|
OPRISM-III | 21.15±10.97 | 18.23±8.76 | 31.45±11.87 | <0.001 |
PRISM-III | 19.28±10.28 | 16.53±8.14 | 28.97±11.26 | <0.001 |
pSOFA | 7.24±3.99 | 9.06±3.57 | 12.38±4.56 | 0.001 |
Glasgow coma scale | 10.66±4.46 | 1.57±1.48 | 2.21±1.86 | 0.097 |
Creatinine (mg/dl) | 0.97±0.89 | 0.96±0.90 | 1.00±0.87 | 0.842 |
Total bilirubin (mg/dl) | 2.47±6.42 | 2.21±6.93 | 3.38±4.15 | 0.390 |
Lactic acid (mmol/L) | 3.79±3.93 | 2.79±2.73 | 7.31±5.31 | <0.001 |
CRP (mg/dl) | 11.85±11.78 | 11.47±11.32 | 13.26±13.45 | 0.478 |
BNP (pg/ml) | 607.86±960.81 | 578.73±924.68 | 1,450.20±1,613.22 | 0.015 |
Use of mechanical ventilator | 82 (62.6) | 58 (56.9) | 24 (82.8) | 0.011 |
Use of vasoactive inotropic agents | 51 (38.9) | 35 (34.3) | 16 (55.2) | 0.042 |
Use of renal replacement therapy | 36 (27.5) | 27 (26.5) | 9 (31) | 0.627 |
Variable | Multivariate (model 1) |
Multivariate (model 2) |
Multivariate (model 3) |
|||
---|---|---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | |
No. of HSCTs | 3.368 (1.297–8.747) | 0.013 | 3.045 (1.190–7.792) | 0.02 | 3.532 (1.435–8.678) | 0.006 |
Septic shock | 0.794 (0.175–3.598) | 0.765 | 1.028 (0.207–5.092) | 0.973 | 0.917 (0.225–3.730) | 0.903 |
OPRISM-III | 1.142 (1.080–1.208) | <0.001 | ||||
PRISM-III | 1.148 (1.082–1.218) | <0.001 | ||||
pSOFA | 1.250 (1.109–1.409) | <0.001 |
Values are presented as number (%), median (interquartile range), or mean±standard deviation. HSCT: hematopoietic stem cell transplantation; PICU: pediatric intensive care unit; HLA: human leukocyte antigen; CMV: cytomegalovirus; TA-TMA: transplant-associated thrombotic microangiopathy.
Values are presented as mean±standard deviation or number (%). PICU: pediatric intensive care unit; OPRISM-III: oncological pediatric risk of mortality-III; PRISM-III: pediatric risk of mortality-III; pSOFA: pediatric Sequential Organ Failure Assessment; CRP: C-reactive protein; BNP: B-type natriuretic peptide.
PICU: pediatric intensive care unit; HR: hazard ratio; CI: confidence incidence; HSCT, hematopoietic stem cell transplantation; OPRISM-III: oncological pediatric risk of mortality-III; PRISM-III: pediatric risk of mortality-III; pSOFA: pediatric Sequential Organ Failure Assessment.