Risks of mortality in children admitted to the paediatric intensive care unit after haematopoietic stem cell transplantation

The risk of mortality in children admitted to the paediatric intensive care unit (PICU) after haematopoietic stem cell transplantation is felt to be very high. Life-threatening complications leading to PICU admission are due to organ toxicity caused by conditioning regimes and graft-versus-host disease (GVHD), systemic infections and other organ dysfunctions. Data collected between October 1998 and December 2001 of paediatric patients undergoing haematopoietic stem cell transplantation and thereafter admitted to the PICU were retrospectively analysed in order to reveal the possible causes and risk factors related to death while in the PICU. Twenty-six PICU admissions were recorded. We found a mortality rate of 57.7% and a 6-month survival rate of 23.1%. Univariate analysis identified an oncological paediatric risk of mortality (O-PRISM) score above 10 points, sustained renal failure and a failed negative fluid balance as significant predictors to non-survival.