Identifying the critically ill paediatric oncology patient

Hospitalised paediatric oncology patients are at risk to develop acute complications. Early identification of clinical deterioration enabling adequate escalation of care remains challenging. Various Paediatric Early Warning Scores (PEWSs) have been evaluated, also in paediatric oncology patients but mostly in retrospective or case control study designs. This study encompasses the first prospective cohort to evaluate the predictive performance of the Bedside Paediatric Early Warning Score (BedsidePEWS) in hospitalised paediatric oncology patients for non-elective PICU admission or cardiopulmonary resuscitation. If the predictive value proves to be suboptimal, simultaneous collection of routine health care and patient monitor data enables us to fit a model for this particular high-risk population. Our ultimate goal is to provide a valuable prediction tool that timely detects critical deterioration in paediatric cancer patients, allowing for adequate (timing of) clinical intervention. This prospective cohort study is conducted at the Princess Máxima Centre, an 80-bed Dutch paediatric oncology hospital, directly connected to a shared 22-bed paediatric intensive care unit (PICU).

We hypothesize that the BedsidePEWS might not have optimal predictive performance for clinical deterioration resulting in unplanned PICU transfer or cardiopulmonary resuscitation in hospitalised paediatric oncology patients and might need optimisation.

Prospective observational cohort study between Feb 1st 2019 and Sep 1st 2021 - continuous data collection.