THE BURDEN OF PEDIATRIC CRITICAL ILLNESS AMONG PEDIATRIC ONCOLOGY PATIENTS IN LOW- AND MIDDLE-INCOME COUNTRIES: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Intensive Care Units
LMICs
outcomes
pediatric cancer
Journal
Critical reviews in oncology/hematology
ISSN: 1879-0461
Titre abrégé: Crit Rev Oncol Hematol
Pays: Netherlands
ID NLM: 8916049
Informations de publication
Date de publication:
08 Aug 2024
08 Aug 2024
Historique:
received:
27
04
2024
revised:
25
07
2024
accepted:
30
07
2024
medline:
11
8
2024
pubmed:
11
8
2024
entrez:
10
8
2024
Statut:
aheadofprint
Résumé
Pediatric oncology patients have increased risk for critical illness; outcomes are well described in high-income countries (HICs); however, data is limited for low- and middle-income countries (LMICs). We systematically searched PubMed, EMBASE, Web of Science, CINAHL and Global Health databases for articles in 6 languages describing mortality in children with cancer admitted to intensive care units (ICUs) in LMICs. Two investigators independently assessed eligibility, data quality, and extracted data. We pooled ICU mortality estimates using random effect models. Of 3,641 studies identified, 22 studies were included, covering 4,803 ICU admissions. Overall pooled mortality was 30.3% [95% Confidence-interval (CI) 21.7-40.6%]. Mechanical ventilation [odds ratio (OR) 12.2, 95%CI:6.2-24.0, p-value<0.001] and vasoactive infusions [OR 6.3 95%CI:3.3-11.9, p-value<0.001] were associated with ICU mortality. ICU mortality among pediatric oncology patients in LMICs is similar to that in HICs, however, this review likely underestimates true mortality due to underrepresentation of studies from low-income countries.
Sections du résumé
BACKGROUND
BACKGROUND
Pediatric oncology patients have increased risk for critical illness; outcomes are well described in high-income countries (HICs); however, data is limited for low- and middle-income countries (LMICs).
METHODS
METHODS
We systematically searched PubMed, EMBASE, Web of Science, CINAHL and Global Health databases for articles in 6 languages describing mortality in children with cancer admitted to intensive care units (ICUs) in LMICs. Two investigators independently assessed eligibility, data quality, and extracted data. We pooled ICU mortality estimates using random effect models.
RESULTS
RESULTS
Of 3,641 studies identified, 22 studies were included, covering 4,803 ICU admissions. Overall pooled mortality was 30.3% [95% Confidence-interval (CI) 21.7-40.6%]. Mechanical ventilation [odds ratio (OR) 12.2, 95%CI:6.2-24.0, p-value<0.001] and vasoactive infusions [OR 6.3 95%CI:3.3-11.9, p-value<0.001] were associated with ICU mortality.
CONCLUSIONS
CONCLUSIONS
ICU mortality among pediatric oncology patients in LMICs is similar to that in HICs, however, this review likely underestimates true mortality due to underrepresentation of studies from low-income countries.
Identifiants
pubmed: 39127134
pii: S1040-8428(24)00210-5
doi: 10.1016/j.critrevonc.2024.104467
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
104467Informations de copyright
Copyright © 2024. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors have no conflict of interest to disclose