Pediatric oncology patients may be at a higher risk of complications and mortality from sepsis compared to their non-oncology counterpart.
The aim of this study is to compare characteristics, treatment, and sepsis-related mortality between oncology and non-oncology patients presenting to a tertiary care medical center emergency department (ED).
This is a retrospective single-centered cohort study including patients with a diagnosis of sepsis, severe sepsis, septic shock, or bacteremia in our academic ED between January 2009 and January 2015
Final diagnosis of sepsis, septic shock or bacteremia.Sepsis and septic shock were defined according to the International Consensus Conference on Pediatric Sepsis.
Suspicion for infection in addition to two of the following four criteria had to be present (with at least one being abnormal temperature or leukocyte count) for inclusion in our study: Core temperature (measured by rectal, bladder, oral, or central probe) of >38.5 or <36°C, Tachycardia, defined as a mean heart rate more than two standard deviations above normal for age, or for children younger than one year of age, bradycardia defined as a mean heart rate <10th percentile for age, Mean respiratory rate more than two standard deviations above normal for age or mechanical ventilation for an acute pulmonary process and Leukocyte count elevated or depressed for age, or >10 percent immature neutrophils. Patients who did not fulfill 2 out of 4 SIRS criteria, but on whom the treating physician documented suspicion for sepsis were also included.
Bacteremia was defined as two positive blood culture sets with skin flora pathogens or one positive blood culture set with non-skin flora pathogens.
Incomplete charts, patients older than 18 years of age, pregnant or presenting secondary to trauma.