PP124 Topic: AS13–Hematology/Oncology/Stem Cell Transplant/Immunology: ARE EXISTING MORTALITY PREDICTION MODELS SUITABLE FOR PEDIATRIC HEMATOLOGY/ONCOLOGY PATIENTS ADMITTED TO THE PEDIATRIC INTENSIVE CARE UNIT DUE TO SEPSIS?

Le résumé fourni par la source

Aims & Objectives: Children with hemato-oncological diseases or post-stem cell transplantation (SCT), are highly susceptible to life-threatening infections, constituting a significant portion of pediatric intensive care unit (PICU) admissions due to sepsis. Standard pediatric prognostic tools may not adequately assess illness severity and mortality risk in this subgroup. Our study aimed to assess the suitability of the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) and the Pediatric Risk of Mortality III (PRISM III) scores in this context and develop a tailored risk-assessment model for these vulnerable patients. Methods: We conducted a retrospective cohort study, at the largest referral pediatric hematology-oncology center in Israel. We collected and analyzed demographics, clinical and laboratory data, and PICU outcomes from all admissions to the PICU due to sepsis of children with hemato-oncological diseases or after SCT, between 2008-2021 (n=233). Results: The survival rate was 83%. The diagnostic capabilities of PELOD-2 and PRISM III, as determined by the area under the receiver operating characteristic curve (AUC), were 82% and 74%, respectively. Models including the existing scoring tools and 9 new clinical parameters (age, SCT, viral or fungal infection, central venous line removal, vasoactive inotropic score, bilirubin, C-reactive protein level, and prolonged neutropenia) significantly improved the above AUCs to 90% (p=0.01) and 87% (p<0.001), respectively. Conclusions: PELOD-2 and PRISM III scores show limited diagnostic accuracy in hemato-oncological children admitted to the PICU with sepsis. Our findings underscore the necessity for a specialized risk-assessment tool, reflective of their distinct features, to be validated in a large multi-center prospective study. Keywords: oncology, Sepsis, PELOD-2

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.