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Risk Factors for Mortality in Asian Children Admitted to the Paediatric Intensive Care Unit after Haematopoietic Stem Cell Transplantation.

Abstract This study aimed to investigate the risk factors associated with mortality in haematopoietic stem cell transplant (HSCT) patients admitted to our paediatric intensive care unit (PICU) over an 8-year period.
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Journal Title annals of the academy of medicine, singapore
Publication Year Start




PMID- 28263341
OWN - NLM
STAT- In-Process
DA  - 20170306
LR  - 20170306
IS  - 0304-4602 (Print)
IS  - 0304-4602 (Linking)
VI  - 46
IP  - 2
DP  - 2017 Feb
TI  - Risk Factors for Mortality in Asian Children Admitted to the Paediatric Intensive
      Care Unit after Haematopoietic Stem Cell Transplantation.
PG  - 44-49
AB  - INTRODUCTION: This study aimed to investigate the risk factors associated with
      mortality in haematopoietic stem cell transplant (HSCT) patients admitted to our 
      paediatric intensive care unit (PICU) over an 8-year period. MATERIALS AND
      METHODS: A retrospective chart review was conducted of all HSCT patients
      requiring PICU admission at our centre (a tertiary care university hospital in
      Singapore) from January 2002 to December 2010. Chief outcome measures were
      survival at the time of PICU discharge and survival at 6 months after initial
      PICU admission. RESULTS: Ninety-eight patients underwent HSCT during this period;
      18 patients (18%) required 24 PICU admissions post-HSCT. The overall survival to 
      PICU discharge was 62.5%. Of those who survived discharge from the PICU, 33% died
      within 6 months of discharge. Non-survivors to PICU discharge had a higher
      incidence of sepsis (89% vs 33%, P = 0.013) and organ failure as compared to
      survivors (cardiovascular failure 100% vs 20%, P = 0.0003; respiratory failure
      89% vs 20%, P = 0.002; and renal failure 44% vs 7%, P = 0.047). Mortality rates
      were higher in patients requiring mechanical ventilation (70% vs 14%, P = 0.010) 
      and inotropic support (70% vs 14%, P = 0.010). Mortality in all patients with
      renal failure requiring haemodialysis (n = 4) was 100%. Presence of 3 or more
      organ failures was associated with 80% mortality (P = 0.003). CONCLUSION: Sepsis,
      multiple organ failure and the need for mechanical ventilation, inotropes and
      especially haemodialysis were associated with increased risk of mortality in our 
      cohort of HSCT patients.
FAU - Santhanam, Haripriya
AU  - Santhanam H
AD  - Department of Paediatrics, National University Health System, Singapore.
FAU - Ong, Jacqueline Sm
AU  - Ong JS
FAU - Shen, Liang
AU  - Shen L
FAU - Tan, Poh Lin
AU  - Tan PL
FAU - Koh, Pei Lin
AU  - Koh PL
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - Ann Acad Med Singapore
JT  - Annals of the Academy of Medicine, Singapore
JID - 7503289
EDAT- 2017/03/07 06:00
MHDA- 2017/03/07 06:00
CRDT- 2017/03/07 06:00
PST - ppublish
SO  - Ann Acad Med Singapore. 2017 Feb;46(2):44-49.

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