Pronostic et facteurs associés chez les patients cancéreux en état critique admis en unité de soins intensifs pédiatriques

Résumé

Background: Despite advances in pediatric oncology, critically ill children with cancer still require PICU admission and face high mortality. Objective: To assess outcomes and identify mortality-associated factors in pediatric oncology patients admitted to the PICU. Methods: A five-year retrospective study (2020-2025) was conducted in the PICU of Farhat Hached Hospital, Sousse. Children aged 0-15 years with confirmed cancer were included. Results: Thirty-eight patients (3.7% of admissions) were included; 60.5% had hematological malignancies, mainly acute lymphoblastic leukemia (44.7%). The main admission reasons were respiratory distress (39.4%) and hemodynamic instability (34.2%). Mechanical ventilation was required in 52.6% and vasoactive support in 26.3%. PICU mortality was 36.8%. Mortality was significantly associated with delayed PICU transfer (>24 h), multiple organ dysfunction, mechanical ventilation, and vasoactive drug use. Conclusion: Mortality remains high in critically ill pediatric oncology patients, particularly in cases of organ failure or delayed PICU admission. Early detection and timely transfer to the PICU are essential to improve outcomes.