P0100 / #666: SURVIVAL OF NEUTROPENIC ENTEROCOLITIS (NEC) ACCORDING TO THE DEGREE OF NEUTROPENIA IN PATIENTS TREATED IN THE INTENSIVE CARE UNIT (ICU).

Abstract

Aims & Objectives: Introduction: NEC is a complication associated with neoplasms and manifests with sepsis and acute abdomen, mortality can increase up to 50%. The phenomenon is associated with bacterial translocation regardless of the degree of neutropenia. However, there is a relationship inversely proportional to the neutrophil count. Objectives: To determine the probability of survival according to the degree of neutropenia classified by the World Health Organization (WHO) in pediatric patients with hemato-oncological diseases with NEC. Methods: Retrospective prognostic cohort study between 2009 and 2017. Setting and Participants: Patients with cancer and NEC (defined by sepsis with neutrophils <1500 cel/mm3 and clinical signs of acute abdomen confirmed by an imaging studies) hospitalized in the ICU. Patients with previous NEC or digestive tract tumors were excluded. Time 0 was considered at the time of admission to the ICU and a follow-up was guaranteed until day 28. The outcome measure was death and the degree of neutropenia by WHO. Survival analysis by Kaplan Meier estimator. Results: 150 patients were included, median age of 93 months (36-147), 87 (57%) were females, mortality was 37%. Leukemia accounts for 52% of neoplasms included. The probability of survival by degree of neutropenia was:1500 cell/mm3 of 79%, 1000-1499 cell/mm3 of 65%, 500-999 cell/mm3 of 45%, 100-499 cell/mm3 of 42%, <100 cell/mm3 was 31% (p<0.001). The hazard ratio(HR) by degree of neutropenia was 3.7 (95% CI, 2.4-18) Conclusions: The mortality rate in these patients was similar to septic shock. We determine a decrease of survival directly proportional to the neutrophil count in our patients