Predictors of Severity Associated with Diminished Survival of Patients
with Febrile Neutropenia Episodes in Patients in an Oncological
Pediatric Intensive Care Unit
Abstract
Background: Febrile neutropenia (FN) is a frequent complication of
chemotherapy treatment in children with oncological diseases. It can
cause serious complications due to infections (SIC), such as severe
sepsis and septic shock. In order to identify the predictors of severity
for diminished survival in these patients, it is important to have a
better treatment strategy, so as to reduce the rate of mortality.
Procedure: Retrospective, descriptive and analytical study conducted
through a review of medical records of cancer patients from 0 to 18
years old with FN episodes admitted to the Pediatric Intensive Care Unit
in Brazil, from June/2013 to January/2018. Epidemiological, clinical and
laboratory variables were analyzed for survival outcome. The rates of
severe sepsis, septic shock, and mortality were also investigated.
Results: Data from 140 FN episodes were analyzed. Most of the children
had hematological diseases (80.8%), the average age was 8.5 years old,
and the main microorganisms identified in cultures were Gram negative
bacteria. The predictors of severity for diminished survival utilizing
multivariate analyses were hematological neoplasms in relapse, abnormal
capillary filling, and a serum calcium value <7 mg/dL. The
rate of severe sepsis was 38.57%, the rate of septic shock was 37.85%,
and the rate of mortality was 25.71%. Conclusion: Predictors of
severity for diminished survival were hematological neoplasms in
relapse, abnormal capillary filling time, and a serum calcium value
lower than 7 mg/dL. The rate of severe sepsis was 38.57%, the rate of
septic shock was 37.85%, and the rate of mortality was 25.71%.