Composite Adverse Event Outcome in Pediatric Cancer Patients with Prolonged Febrile Neutropenia

Authors : Muhammad MATLOOB
Pages : 69-73
Doi:10.5799/jmid.vi.328804
View : 40 | Download : 5
Publication Date : 2016-06-01
Article Type : Research Paper
Abstract :Objective: Pediatric cancer patients with prolonged febrile neutropenia have increased risk for severe, recurrent or new bacterial and fungal infection. The aim of this study was to identify the risk factors associated with adverse outcomes in this group. Methods: We retrospective analyzed the clinical data of 135 hospitalizations of pediatric cancer patients with prolonged febrile neutropenia from a tertiary health care center of Pakistan. Results: The mean age of the study population was 7.3±4.1 years. There were 98 insert ignore into journalissuearticles values(72.6%); males and 37 insert ignore into journalissuearticles values(27.4%); females. Acute leukemia with 88 patients insert ignore into journalissuearticles values(65.2%); was the most common diagnosis followed by lymphomas 19 patients insert ignore into journalissuearticles values(14.1%); and solid tumors. Cause of febrile neutropenia was identified in only 58 insert ignore into journalissuearticles values(43.0%); patients, out of them blood stream infections were found in 22 cases insert ignore into journalissuearticles values(16.3%);, pneumonia in 15 insert ignore into journalissuearticles values(11.1%);, fungal infection in 13 insert ignore into journalissuearticles values(9.6%);, infectious diarrheas in 5 insert ignore into journalissuearticles values(3.7%); and urinary tract infection insert ignore into journalissuearticles values(UTI); in 3 insert ignore into journalissuearticles values(2.2%); of cases. The composite adverse event outcome was observed in 28 insert ignore into journalissuearticles values(20.7%); of patients, with in-hospital mortality occurring in 7 insert ignore into journalissuearticles values(5.2%);, Pediatric intensive care unit insert ignore into journalissuearticles values(PICU); admission occurring in 12 insert ignore into journalissuearticles values(8.9%); and inotropic support was required in 9 insert ignore into journalissuearticles values(6.7%);. On logistic regression analysis AML insert ignore into journalissuearticles values(Adjusted odds ratio insert ignore into journalissuearticles values(AOR);, 7.6; P<0.001);, neutropenia <50/mm3 insert ignore into journalissuearticles values(AOR, 10.8; p<0.001);, platelets count <50,000/mm3 insert ignore into journalissuearticles values(AOR, 5.2; p<0.001);, BSI insert ignore into journalissuearticles values(AOR, 2.3; p 0.05); and fungal infection insert ignore into journalissuearticles values(AOR, 4.3; p<0.001); were found as independent risk factors for composite adverse event outcome in pediatric cancer patients with prolonged febrile neutropenia. Conclusions: AML, severe myelosuppression, blood stream infections and fungal infection were identifiable risk factors associated with development of adverse event outcome in pediatric cancer patients with prolonged febrile neutropenia. J Microbiol Infect Dis 2016;6insert ignore into journalissuearticles values(2);: 69-73   
Keywords : Febrile neutropenia, pediatric, oncology, adverse outcome

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