TY - JOUR
T1 - The Burden of Pediatric Critical Illness Among Pediatric Oncology Patients in Low- and Middle-income Countries
T2 - A Systematic Review and Meta-analysis
AU - Gabela, Alejandra
AU - Wösten-van Asperen, Roelie M
AU - Arias, Anita V
AU - Acuña, Carlos
AU - Zebin, Zebin Al
AU - Lopez-Baron, Eliana
AU - Bhattacharyya, Parthasarathi
AU - Duncanson, Lauren
AU - Ferreira, Daiane
AU - Gunasekera, Sanjeeva
AU - Hayes, Samantha
AU - McArthur, Jennifer
AU - Nagarajan, Vaishnavi Divya
AU - Torres, Maria Puerto
AU - Rivera, Jocelyn
AU - Sniderman, Elizabeth
AU - Wrigley, Jordan
AU - Zafar, Huma
AU - Agulnik, Asya
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/11
Y1 - 2024/11
N2 - Background: Pediatric oncology patients have increased risk for critical illness; outcomes are well described in high-income countries (HICs); however, data is limited for low- and middle-income countries (LMICs). Methods: We systematically searched PubMed, EMBASE, Web of Science, CINAHL and Global Health databases for articles in 6 languages describing mortality in children with cancer admitted to intensive care units (ICUs) in LMICs. Two investigators independently assessed eligibility, data quality, and extracted data. We pooled ICU mortality estimates using random effect models. Results: Of 3641 studies identified, 22 studies were included, covering 4803 ICU admissions. Overall pooled mortality was 30.3 % [95 % Confidence-interval (CI) 21.7–40.6 %]. Mechanical ventilation [odds ratio (OR) 12.2, 95 %CI:6.2–24.0, p-value<0.001] and vasoactive infusions [OR 6.3 95 %CI:3.3–11.9, p-value<0.001] were associated with ICU mortality. Conclusions: ICU mortality among pediatric oncology patients in LMICs is similar to that in HICs, however, this review likely underestimates true mortality due to underrepresentation of studies from low-income countries.
AB - Background: Pediatric oncology patients have increased risk for critical illness; outcomes are well described in high-income countries (HICs); however, data is limited for low- and middle-income countries (LMICs). Methods: We systematically searched PubMed, EMBASE, Web of Science, CINAHL and Global Health databases for articles in 6 languages describing mortality in children with cancer admitted to intensive care units (ICUs) in LMICs. Two investigators independently assessed eligibility, data quality, and extracted data. We pooled ICU mortality estimates using random effect models. Results: Of 3641 studies identified, 22 studies were included, covering 4803 ICU admissions. Overall pooled mortality was 30.3 % [95 % Confidence-interval (CI) 21.7–40.6 %]. Mechanical ventilation [odds ratio (OR) 12.2, 95 %CI:6.2–24.0, p-value<0.001] and vasoactive infusions [OR 6.3 95 %CI:3.3–11.9, p-value<0.001] were associated with ICU mortality. Conclusions: ICU mortality among pediatric oncology patients in LMICs is similar to that in HICs, however, this review likely underestimates true mortality due to underrepresentation of studies from low-income countries.
KW - Intensive Care Units
KW - LMICs
KW - Outcomes
KW - Pediatric cancer
UR - http://www.scopus.com/inward/record.url?scp=85201606259&partnerID=8YFLogxK
U2 - 10.1016/j.critrevonc.2024.104467
DO - 10.1016/j.critrevonc.2024.104467
M3 - Review article
C2 - 39127134
SN - 1040-8428
VL - 203
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
M1 - 104467
ER -