ArticleJornal de pediatria
Children with malignancies and septic shock - an attempt to understand the risk factors.
Article in Jornal de pediatria. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Predictors of mortality of pediatric cancer patients admitted to the intensive care unit in a low-middle-income country.Frontiers in pediatrics · 2026Article
- Application of metagenomic next-generation sequencing technology in hematologic malignancy patients with sepsis following antibiotic use.BMC infectious diseases · 2025Article
- Article
- New sepsis-associated morbidity and mortality in pediatric oncology patients.Frontiers in oncology · 2025Article
- Article
- Comparing the clinical characteristics and outcomes of septic shock children with and without malignancies: a retrospective cohort study.Jornal de pediatriaArticle
- Management of septic shock in children with cancer-Common challenges and research priorities.Jornal de pediatriaArticle
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4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo explain the high mortality of septic shock in children with cancer.
methodsA retrospective cohort from 2016 to 2020, of children aged 0 to 18 years, and septic shock.
resultsThe authors included 139 patients. Acute lymphocytic leukemia was the most frequent diagnosis (16.5%), and Gram-negative bacteria were the most frequent blood culture isolates (22.3%). There were 57 deaths in ICU (41%), 10 in the first 24 hours of shock (early death). A LASSO model with variables: neutropenia (coefficient 0.215), respiratory (0.81), hematological (1.41), and neurological (0.72) dysfunctions, age (-0.002) and solid tumor recurrence (0.34) generated AUC = 0.79 for the early death outcome. Survivors had significant differences in the PRISM-IV score (mean ± SD 10.9 ± 6.2 in the survivors, 14.1 ± 6.5 in the deceased, p = 0.004), and in the mean number of organ dysfunctions (3.2 ± 1.1 in the survivors, 3.8 ± 6.5 in the deceased, p < 0.001). A positive fluid balance in the first 24 hours of sepsis between 2% and 6% of body weight showed a reduction effect on the probability of death in ICU (hazard ratio 0.47, 95% CI 0.24-0.92, p = 0.027). The recurrence of any cancer was a predictor of in-hospital death, regardless of severity.
conclusionsRecurrence of any cancer is an important risk of sepsis-related death. A positive fluid balance between 20 and 60 mL/kg or 2% and 6% of body weight in the first 24 hours after the onset of sepsis is related to lower mortality.
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