Risk factors of in-hospital death in pediatric patients with hemophagocytic lymphohistiocytosis: A case-control study

Background: Early mortality in patients with hemophagocytic lymphohistiocytosis (HLH) remains largely high. The aim of our study was to comprehensively analyze the risk factors for in-hospital death in HLH patients. Methods A retrospective case-control study was conducted at West China Second Hospital of Sichuan University from January 2014 to December 2020. All pediatric patients diagnosed with HLH who were hospitalized for more than 24 hours were considered for inclusion. Collect demographic, laboratory, clinical, genetic profile, treatment information, and outcome data from records. Multivariable logistic regression models were used to evaluate the risk factors of in-hospital death. Results 150 pediatric patients with HLH were enrolled in the study. The median age of patients was 54 months (IQR 25–107) and 94 (62.7%) were men. The median length of hospital stay was 17 days (IQR 8-27.5). The overall in-hospital mortality rate for the cohort was 8%. Multivariable regression analysis showed that hyperlactatemia (OR = 8.018, 95%CI 1.202–53.471, p  = 0.032) and CRRT (OR = 7.746, 95%CI 1.258–47.680, p  = 0.027) were associated with higher risk of in-hospital mortality. Conclusions These data suggest that hyperlactatemia and CRRT use in pediatric patients with HLH were associated with increased in-hospital mortality.