Hospitalization in the Intensive Care Unit of Children with Acute Lymphoblastic Leukemia: A Retrospective Cohort Study.
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BACKGROUND: To examine how sociodemographic factors like age, gender, ethnicity, and socioeconomic status relate to early precursors of ALL (acute lymphoblastic leukemia), evaluate their distribution among Acute Lymphoblastic Leukemia (ALL) variants, FAB (French-American-British) classification, and comorbidities, and explore associated clinical profiles. Then, assess their significance on therapy outcomes in ICU (intensive care unit) settings. METHODS: A retrospective cohort study investigated the association between early detection of critical condition precursors and outcomes in pediatric ALL patients. Data from 188 ICU-admitted children were analyzed, exploring sociodemographic, clinical factors, and ICU outcomes, using SPSS for statistical analysis. Statistical methods included chi-square tests for categorical variables, independent sample t-tests for continuous variables, and multivariate logistic regression to identify prognostic factors influencing ICU outcomes. RESULTS: The study on ICU hospitalization of children with ALL revealed several important findings. Of 188 children admitted to the ICU, 98 (52.1%) were aged 8-18 years and 97 (51.6%) were male. Most participants had a weight ≤30 kg (56.9%) and reduced BMI (63.3%). The common ALL variant was most frequent (76, 40.4%). During ICU stay, 50 patients (26.6%) died and 138 (73.4%) were transferred to specialized oncology care. During the study period, 165 (87.8%) patients had a single ICU admission, while 23 (12.2%) experienced two or more ICU admissions. Male patients were more often transferred to oncology care (80/97, 82.5%; P=0.004). Mortality was significantly higher among those with reduced BMI (26/69, 37.7%; P=0.009) and concomitant diseases (15/33, 45.5%; P=0.007). Logistic regression identified male gender (Exp(B)=3.031, P=0.003) and concomitant diseases (Exp(B)=2.538, P=0.033) as significant predictors of adverse outcomes. Re-hospitalization frequency was associated with higher weight (mean 48.9 ± 23.3 kg vs. 27.7 ± 16.2 kg, P<0.001). CONCLUSION: This study identified key prognostic factors in pediatric ALL patients in the ICU, including gender, concomitant diseases, BMI, relapse, and risk group. These factors significantly influenced mortality and re-hospitalization rates, underscoring the importance of tailored management strategies for improved outcomes.