Predictive Risk Score of Respiratory Complications in Children with Mediastinal Tumors (2022)

Received: 18 January 2022 | Revised: 9 April 2022 | Accepted: 13 June 2022 DOI: 10.1002/cam4.4972 RESEARCH ARTICLE Predictive risk score of respiratory complications in children with mediastinal tumors: A ca...

Received: 18 January 2022 | Revised: 9 April 2022 | Accepted: 13 June 2022 DOI: 10.1002/cam4.4972 RESEARCH ARTICLE Predictive risk score of respiratory complications in children with mediastinal tumors: A case–­control study Mamoru Honda1 | Arakawa Yuki1 | Hosokawa Takahiro2 | Oyama Chigusa1 | Mitani Yuichi1 | Mori Makiko1 | Kohei Fukuoka1 | Oshima Koichi1 | Tanami Yutaka2 | Ishimaru Tetsuya3 | Kawashima Hiroshi3 | Mizuta Koichi3 | Ueta Ikuya4 | Kuratani Norifumi5 | Koh Katsuyoshi1 1 Department of Hematology/Oncology, Saitama Children's Medical Center, Abstract Saitama, Japan Background: The aim of this study was to examine risk factors of respiratory 2 Department of Radiology, Saitama complications at the diagnosis and establish an algorithm of clinical management Children's Medical Center, Saitama, Japan in children and adolescents with mediastinal tumors. 3 Department of Pediatric Surgery, Methods: We retrospectively collected clinical information of all children and ad- Saitama Children's Medical Center, olescents who presented with mediastinal tumors at Saitama Children's Medical Saitama, Japan Center from 1999 to 2019, including age, sex, pathological diagnosis, eight major 4 Department of Pediatric Intensive clinical symptoms (cough, dyspnea, hypoxia, orthopnea, chest pain, wheeze, su- Care, Saitama Children's Medical Center, Saitama, Japan perior vena cava syndrome, and stridor), chest computed tomography (CT) find- 5 Department of Anesthesia, Saitama ings (tumor location, mediastinal mass ratio, pleural fluid, pericardial effusion, Children's Medical Center, Saitama, and compression of trachea and bronchi), types of diagnostic procedure and an- Japan esthesia, respiratory complications (severe hypoxia, difficult ventilation, respira- Correspondence tory failure, and cardiopulmonary arrest), and clinical outcome. Subsequently, Mamoru Honda, Department of we calculated the risk score for predicting respiratory complications by combin- Pediatric Hematology/Oncology, Saitama Children's Medical Center, 1-­2, ing clinical and radiological findings. Shintoshin, Chuou-­ku, Saitama, 330-­ Results: Of the 57 patients, 7 (12%) developed respiratory complications. Cough, 8777, Japan. dyspnea, hypoxia, and orthopnea were significantly more common in patients Email: [email protected] with complications (p = 0.02, p = 0.02, p < 0.01, p = 0.03, respectively). The re- duction of percentage of tracheal cross-­sectional area (%TCA) and compression of the carina in chest CT were also significantly more common in patients with complications (p < 0.01 and