Meyer et al developed a risk score for predicting mortality in a pediatric cancer patient admitted to the intensive care unit (ICU). This can identify a patient who may require more aggressive management. The authors are from University Hospital of Saarland in Homburg, Germany.
Parameters:
(1) type of malignancy
(2) number of organ failures (cardiovascular, respiratory, neurological, hematological, and renal)
(3) neutropenia (absolute neutrophil count < 500 per µL)
(4) septic shock
(5) mechanical ventilation
(6) inotropic medication
|
Parameter |
Finding |
Points |
|
type of malignancy |
solid |
0 |
|
|
non-solid (leukemia, lymphoma) |
1 |
|
number of organ failures |
0 to 2 |
0 |
|
|
>= 3 |
1 |
|
neutropenia |
absent |
0 |
|
|
present |
1 |
|
septic shock |
absent |
0 |
|
|
present |
1 |
|
mechanical ventilation |
absent |
0 |
|
|
present |
1 |
|
inotropic medication |
absent |
0 |
|
|
present |
1 |
total risk score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score of 4 or more is associated with increased mortality.
Performance:
• The sensitivity was 100% and specificity 92%.
• The positive predictive value is 100% and negative predictive value is 78%.
Limitation:
• The score needs to be validated in a larger study.
• The score should not be used to make decisions for an individual patient.
Purpose: To evaluate a pediatric cancer patient admitted to the intensive care unit (ICU) using the mortality risk score of Meyer et al.
Specialty: Critical Care, Emergency Medicine, Hematology Oncology, Surgery, general
Objective: risk factors, selection
ICD-10: C80.9,
