734: MORTALITY TREND FROM SEPSIS IN PEDIATRIC ONCOLOGY PATIENTS 2016-2019

Abstract

Introduction: Sepsis continues to be a major cause of mortality in the pediatric oncologic population, and thus has been the subject of ongoing research. Whether improvements in chemotherapy and other advancements, especially the implementation of pediatric sepsis guidelines with early identification, has affected mortality in the pediatric cancer population is up for debate. We hypothesized that advances in chemotherapy regimens, including the introduction of immunologics, and early early identification of sepsis would decrease deaths in oncologic patients diagnosed with sepsis. Thus we aimed to identify and characterize deaths in oncologic patients who also diagnosed with sepsis. Methods: We analyzed the 2016 and 2019 Kids inpatient database (KID) data and noted the overall percentage of deaths from sepsis. We identified all patient mortalities with an oncologic as well as sepsis diagnostic code. T-test was conducted to find statistical differences between the incidence of deaths in these patients. In addition, we stratified each year into different cancer types and further characterized their demographic characteristics and identified other complications (i.e. if they developed acute renal failure) during their hospital stay. Results: In 2016, of the 1021 deaths in patients with an oncologic diagnosis, 264 (26%) had a sepsis diagnostic code. In 2019, there were 955 pediatric patients with oncologic diagnoses who died, and of those 230 (24%) had a sepsis diagnostic code. T-test revealed no statistical significance between both incidences of deaths with a P value 0.5. In both 2016 and 2019, most oncologic patients who died with a sepsis diagnosis had some form of leukemia, 59% in 2019 and 60% in 2016. Conclusions: With the stagnant mortality numbers over three years, more attention must be made to understanding and treating sepsis in this group. Are specific chemotherapies more likely to predispose certain groups to sepsis? Also, regardless of its high prevalence, the high proportion of leukemic patients does warrant further investigation. Specifically, what features of their immunologic response to infection and their chemotherapy regimens predispose them to mortality from sepsis. With the stagnation of mortality in oncologic patients from sepsis, further attention must be placed on this high-risk group.