Pattern and Treatment Outcome of Children With Oncologic Emergencies Seen at First Visit to Pediatric Emergency Unit, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2024-01
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Addis Ababa University
Abstract
Background:Pediatric oncologic emergencies can occur at any time during a child's course of care for cancer; it can be
either the initial manifestation of cancer or occur as a consequence. Pediatric oncologic emergencies may
lead to acute and potentially life-threatening complications unless timely diagnosed and treated. Pediatric
oncologic emergencies can be metabolic emergencies, neurological emergencies, thoracic emergencies,
gastrointestinal emergencies, urogenital emergencies, acute respiratory distress syndrome (ARDS), and
febrile neutropenia. To our knowledge, there is no study done in our country on the pattern and treatment
outcome of oncologic emergencies in the pediatric emergency ward admission during the initial visit.
Objective: To determine the pattern and treatment outcome of children with oncologic emergencies seen
at the first visit to the Pediatric Emergency Unit, TASH from January 2022 to January 2024
Method:A hospital-based retrospective cross-sectional study was conducted in TASH with all selected 240
patients who attended the pediatrics emergency unit from January 2022 to January 2024. Data was
collected by quota sampling method and analysis was done using SPSS version 25. Statistical significance
was considered at a level of significance of 5%, and with a 95% confidence interval (CI) using a Chi-
square to present the estimates of the association. The results were presented using text, tables, and charts.
Results:There were 6,307 pediatric emergency admissions during the study period, and oncologic emergencies
contributed to 3.8% of pediatric emergency unit admissions. A total of 240 pediatric patients were
included in the study. Most of the patients; 80.8% were between the age of 1-9 years and 61.7% were
male with a male-to-female ratio of 1.6:1. The major presenting symptoms were abdominal swelling
(20.8%) followed by easy fatigability (17.5%), and neck swelling (13.3%). The most common oncologic
emergencies in pediatric emergency visits were tumor lysis syndrome (42.5%), hyperleukocytosis
(28.3%), and increased intracranial pressure (14.1%). About 44% of patients stayed at the ER for more
than 1 week’; 80% of the patients were admitted to the inpatient oncology ward, and 6.3% were linked to
the outpatient oncology center. The most common childhood cancers were Acute Lymphoblastic
Leukemia (40%), Brain tumors (15%), and non-Hodgkin’s Lymphoma (12%). About 95% of the study
patients survived, and 5% of the patients did not survive the oncologic emergency during their stay at the
pediatric emergency unit. The duration of illness, vital sign status at admission, oxygen saturation, type of
primary cancer, serum uric acid level, and electrolytes (potassium, phosphorous, Calcium) were
significantly associated with the survival of patients with oncologic emergencies.
Conclusion: Our finding revealed that Tumor Lysis Syndrome was the most common oncologic
emergency in children with cancer. The mortality rate in children with oncologic emergencies at the
pediatric emergency unit was low in our setup.
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Keywords
Cancer, pattern, Tikur Anbessa Specialized Hospital, Oncologic emergency, survival