ArticleCancer2021
Clinical and organizational risk factors for mortality during deterioration events among pediatric oncology patients in Latin America: A multicenter prospective cohort.
Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Etiology of hospital mortality in children living in low- and middle-income countries: a systematic review and meta-analysis.Frontiers in pediatrics · 2024Pooled it
- Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem cell transplantation through golden hour care in a low- and middle-income country: a 10-year analysis.Critical care science · 2026Article
- Oncology Education in Latin America: A Systematic Review of Curricular Gaps, Teaching Strategies, and Regional Initiatives.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Review
- Strategies to improve healthcare team communication structure and quality in resource-variable childhood cancer hospitals (TeamTalk): a study protocol.Implementation science communications · 2025Article
- Implementing and evaluating a Paediatric Early Warning System (PEWS) at a National Referral Hospital in Botswana.BMJ paediatrics open · 2025Article
- Multilevel mortality risk factors among pediatric hematology-oncology patients with deterioration.Cancer · 2025Article
- Variation in Cost Centers Following Gastrointestinal Cancer Surgery.Annals of surgical oncology · 2025Article
- Integrated Pediatric Intensive Care and Hematopoietic Stem Cell Transplantation Service Improves The Peri-Transplant Survival In Children.Blood cell therapy · 2025Article
- Prevalence, aetiology, and hospital outcomes of paediatric acute critical illness in resource-constrained settings (Global PARITY): a multicentre, international, point prevalence and prospective cohort study.The Lancet. Global health · 2025Article
- Impact of implementing a pediatric early warning system on outcomes in hematopoietic stem cell transplant units in South America and Europe.Frontiers in oncology · 2025Article
- Risk Factors and Clinical Management Strategies for Bloodstream Infections in Pediatric Hematological Malignancies.Risk management and healthcare policy · 2025Article
- Comparison of CytoSorb and Jafron HA330 Hemoadsorption Devices in Pediatric Oncological Patients with Sepsis: Retrospective Observational Study.Journal of clinical medicine · 2024Article
- [Infographic and pamphlet development creation to communicate EVAT to pediatric].Psicooncologia · 2024Article
- Connecting Clinical Capacity and Intervention Sustainability in Resource-Variable Pediatric Oncology Centers in Latin America.Global implementation research and applications · 2024Article
- Assessment of the quality of interdisciplinary communication (CritCom): evaluation and refinement of a center summary report.Frontiers in oncology · 2024Article
- Sustainability determinants of an intervention to identify clinical deterioration and improve childhood cancer survival in Latin American hospitals: the INSPIRE study protocol.Implementation science communications · 2023Article
- Effect of paediatric early warning systems (PEWS) implementation on clinical deterioration event mortality among children with cancer in resource-limited hospitals in Latin America: a prospective, multicentre cohort study.The Lancet. Oncology · 2023Article
- Stages of change: Strategies to promote use of a Pediatric Early Warning System in resource-limited pediatric oncology centers.Cancer medicine · 2023Article
- Development and pilot testing of PROACTIVE: A pediatric onco-critical care capacity and quality assessment tool for resource-limited settings.Cancer medicine · 2023Article
- Collaboration for success: the Global Initiative for Childhood Cancer in Latin America.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 14 institutions in 9 countries.
Funding
Abstract
backgroundHospitalized pediatric hematology-oncology (PHO) patients have frequent clinical deterioration events (CDE) requiring intensive care unit (ICU) admission, particularly in resource-limited settings. The objective of this study was to describe CDEs in hospitalized PHO patients in Latin America and to identify event-level and center-level risk factors for mortality.
methodsIn 2017, the authors implemented a prospective registry of CDEs, defined as unplanned transfers to a higher level of care, use of ICU-level interventions on the floor, or nonpalliative floor deaths, in 16 PHO centers in 10 countries. PHO hospital admissions and hospital inpatient days were also reported. This study analyzes the first year of registry data (June 2017 to May 2018).
resultsAmong 16 centers, 553 CDEs were reported in PHO patients during 11,536 admissions and 119,414 inpatient days (4.63 per 1000 inpatient days). Event mortality was 29% (1.33 per 1000 inpatient days) but ranged widely across centers (11%-79% or 0.36-5.80 per 1000 inpatient days). Significant risk factors for event mortality included requiring any ICU-level intervention on the floor and not being transferred to a higher level of care. Events with organ dysfunction, a higher severity of illness, and a requirement for ICU intervention had higher mortality. In center-level analysis, hospitals with a higher volume of PHO patients, less floor use of ICU intervention, lower severity of illness on transfer, and lower rates of floor cardiopulmonary arrest had lower event mortality.
conclusionsHospitalized PHO patients who experience CDEs in resource-limited settings frequently require floor-based ICU interventions and have high mortality. Modifiable hospital practices around the escalation of care for these high-risk patients may contribute to poor outcomes. Earlier recognition of critical illness and timely ICU transfer may improve survival in hospitalized children with cancer.
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Registered trials
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