Outcomes of pediatric rapid response teams at a hematology/oncology center in Riyadh, Saudi Arabia

Background: There is limited evidence on the implementation and outcomes of rapid response teams (RRTs) in hematology/oncology centers. This study aims to evaluate the outcomes, clinical characteristics, and risk factors associated with 30-day mortality in pediatric hematology/oncology patients following RRT activation. Methods: This retrospective study included RRT encounters at a pediatric hematology/oncology center in Riyadh, Saudi Arabia, from 2020 to 2021. Results : Of 660 RRT encounters, 60.0% were males with a median age of 5 years interquartile range ((IQR): 2–10). Common reasons for rapid response team (RRT) activation were sepsis (47.7%), respiratory (16.1%), and cardiovascular disease (14.7%). The most encountered diagnosis classes were leukemia (36.4%), solid tumors (18.5%), and bone marrow transplant (BMT) (14.2%). The pediatric intensive care unit admission rate was 28.5%, with a median stay of 3 days (IQR: 2–7). The univariate analysis identified respiratory distress ( p = 0.004), BMT ( p = 0.042), desaturation ( p < 0.001), tachypnea ( p < 0.001), and high-flow nasal cannula (HFNC) use ( p < 0.001) were associated with 30-day mortality. However, cardiovascular ( p = 0.044) and fever ( p = 0.014) were negatively associated with mortality. The multivariate analysis identified desaturation ( p = 0.032), tachypnea ( p = 0.027), and HFNC use ( p < 0.001) were significantly linked to higher mortality. Meanwhile, fever was associated with reduced mortality risk (odds ratio: 0.4, p = 0.024). Conclusion : The study highlights the need for more evidence on RRT use in immunocompromised pediatric populations and those with complex diseases. Early recognition of high-risk symptoms, personalized RRT activation criteria, and advanced respiratory monitoring could significantly reduce mortality and improve care for critically ill pediatric patients in hematology/oncology settings.