Mónica V. Cárdenas-Monsibaiz, Servicio de Pediatría, Hospital General Regional No 2, Instituto Mexicano del Seguro Social, Querétaro de Arteaga, Querétaro., México
Enrique Villarreal-Ríos, Unidad de Investigación Epidemiológica y en Servicios de Salud Querétaro, Instituto Mexicano del Seguro Social, Querétaro de Arteaga, Querétaro., México
Karla E. Margain-Pérez, Coordinación de Educación e Investigación en Salud, Unidad de Medicina Familiar No 15, Instituto Mexicano del Seguro Social, Querétaro de Arteaga, Querétaro., México
Liliana Galicia-Rodríguez, Unidad de Investigación Epidemiológica y en Servicios de Salud Querétaro, Instituto Mexicano del Seguro Social, Querétaro de Arteaga, Querétaro., México
Jesús González-Aparicio, Servicio de Oncología Pediátrica, Hospital General Regional No 2. Instituto Mexicano del Seguro Social, Querétaro de Arteaga, Querétaro., México
Background: The “Golden Hour” initiative is intended to reduce serious complications in pediatric oncology patients with febrile neutropenia, and it refers to the administration of broad-spectrum antibiotics within the first hour of care in the emergency department. Patients with acute lymphoblastic leukemia are at high risk due to prolonged immunosuppression. The objective was to determine the administration of antibiotics within the first 60 minutes as a factor associated with a lower incidence of sepsis in patients with acute lymphoblastic leukemia. Methods: Retrospective cohort design in the records of pediatric patients diagnosed with acute lymphoblastic leukemia, with groups organized based on the time of antibiotic administration after triage admission. In the timely administration group (≤ 60 minutes), 44 patients were studied, and in the delayed care group (> 60 minutes), 11 patients. The diagnosis of sepsis used the Phoenix criteria as a reference. The time between triage and antibiotic administration was measured in minutes. The statistical analysis included simple logistic regression and calculation of the probability of the event occurring. Results: Fifty-four percent of the late-care group developed sepsis, while in the timely-care group the incidence was 22.7% (p = 0.038). The logistic regression model reported significance (p = 0.004). The probability of developing sepsis was 49.1% at 80 minutes, 35.5% at 60 minutes, and 56% at 90 minutes. Conclusions: Antibiotic administration within the first 60 minutes was associated with a lower incidence of sepsis in patients with acute lymphoblastic leukemia.
Keywords: Acute lymphoblastic leukemia. Sepsis. Oncology. Pediatrics.