The Risk Factors of Septic Shock in Childhood Cancer Patients with Neutropenic Fever

Ban, Ji Eun; Noh, Kyu Tae; Lee, Young Ho

Abstract

PURPOSE: We evaluated the easily-assessable risk and prognostic factors of septic shock in children with neutropenic fever (NF) which developed after anticancer chemotherapy.
METHODS
We retrospectively reviewed the medical records and laboratory data of 97 children who received anticancer chemotherapy at Dong-A University Hospital and had NF between March, 1993 and February, 2001.
RESULTS
There were 223 episodes of NF in 97 children, of which 71 episodes (31.8%) of bacteremia and 18 episodes (8.1%) of septic shock developed. The incidence of septic shock was associated with fever duration (> 5 days, odds ratio=7.367, P=0.0159), tachycardia (odds ratio=11.857, P=0.0001), and serum bicarbonate level (<24 mEq/L, odds ratio=6.235, P=0.0378), whereas not with the underlying disease, age, sex, causative organisms, absolute neutrophil count, absolute monocyte count, absolute phagocyte count, the presence of central venous catheter, the accompanied focal infection, and the use of hematopoietic growth factor. Septic shock developed 3.2 (1~11) days after NF. The prognosis of septic shock patients was not associated with the therapeutic timing, antibiotics, fever duration, tachycardia, or serum bicarbonate level.
CONCLUSION
We suggest that the fever duration, tachycardia, and serum bicarbonate level could be important risk factors of septic shock in children with NF. Although We could not reveal the prognostic factors in children with septic shock, further studies will be required.