Comorbidity Index as a Predictor of Mortality in Pediatric Patients With Solid Tumors

Frontiers in Pediatrics

article

Luz María Torres-Espíndola¹  Manuel De Jesús Castillejos-López²  Joel Demetrio-Ríos¹  Liliana Carmona-Aparicio³  César Galván-Díaz¹  Martín Pérez-García¹  Juan Luís Chávez-Pacheco¹  Julio Granados-Montiel⁴  Israel Torres-Ramírez de Arellano⁵  Arnoldo Aquino-Gálvez⁶ 

[1] Pharmacology Laboratory, National Institute of Pediatrics;Epidemiological Surveillance Unit, National Institute of Respiratory Diseases;Neuroscience Laboratory, National Institute of Pediatrics;Tissue Engineering, Cell Therapy and Regenerative Medicine Unit, National Institute of Rehabilitation;Pathology Department, National Institute of Neurology and Neurosurgery;Biomedical Oncology Laboratory, National Institute of Respiratory Diseases

关键词: charlson comorbidity index;    solid tumor;    pediatric;    cancer;    chemotherapy;    mortality;   

DOI  :  10.3389/fped.2019.00048

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose: The objective of this study was to determine whether a comorbidity index could be used to predict mortality in pediatric patients with chemotherapy-treated solid tumors. Methods: Pediatric patients who underwent chemotherapy treatment for solid tumors were included, and demographic, clinical, and comorbidity data were obtained from patient electronic records. Results: A total of 196 pediatric patients with embryonic solid tumors were included. Metastatic tumors were the most frequently observed ( n = 103, 52.6%). The most common comorbidities encountered for the Charlson comorbidity index (CCI) were cellulitis ( n = 24, 12.2%) and acute renal failure ( n = 15, 7.7%). For the Pediatric Comorbidity Index (PCI), the most frequent comorbidities were pneumonia and sepsis, with n = 64 (32.7%) for each. We evaluated established the prognostic values for both indexes using Kaplan-Meier curves, finding that the CCI and PCI could predict mortality with p < 0.0001. Conclusion: Using the PCI, we observed 100% survival in patients without comorbidities, 70% survival in patients with a low degree of comorbidity, and 20% survival in patients with a high degree of comorbidity. Greater discrimination of probability of survival could be achieved using degrees of comorbidity on the PCI than using degrees of comorbidity on the CCI. The application of the PCI for assessing the hospitalized pediatric population may be of importance for improving clinical evaluation.

【 授权许可】

CC BY