Clinical deterioration of the Pediatric Cancer Patient using the Early Warning Assessment Scale, Hospital Escuela, 2017-2020

Abstract

Background: events of clinical deterioration are reported in up to 38% of hospitalized pediatric cancer patients.

Objective: To characterize the clinical deterioration of pediatric oncology patients using Early Warning Assessment Scale for Honduras (EVATH).

Methods: retrospective cohort study longitudinal, universe 869 records of pediatric oncology patients hospitalized in the Pediatric Hematology-Oncology Ward of Hospital Escuela in the period from January 2017 to December 2020. Sample size n=124 was determined, with an expected prevalence of 11.8% of deterioration events, confidence level (NC95%) and type II error 5.3%, the selection was probabilistic. For the analysis, descriptive statistics (NC95%) and confidence intervals and p value (<0.05) were determined, in addition to sensitivity, specificity, and negative and positive predictive values.

Results: 12.9% (16/124) presented clinical deterioration. Male patients with deterioration 68.7% (11/16) and without deterioration 50.0% (55/108). Most frequent age 6-12 years patients with deterioration 50.0% (8/16) and without deterioration 39.8% (43/108). No differences between groups according to sex and age (p>0.05). Classification according to EVATH score was low risk patients with deterioration 87.6% (14/16) and without deterioration 100.0% (108/108). With a statistically significant association between groups p=0.001 (RR: 0.17; 95% CI: 0.12-0.25).

Conclusion: 12.95 of the patients presented clinical deterioration, and 68.8% required transfer to Pediatric Intensive Care Unit (PICU) secondary to sepsis/septic shock; with death of almost half of the patients who presented an event of clinical deterioration.