e22535 Background: Children cancer is the second cause of mortality, most of deaths are related to infectious complications due to immunosuppression provoked by chemotherapy. Febrile neutropenia is one of the most common issues in oncological patients and it’s considered an emergency. Studies have tried risk predicting models implementation, although they still need to be validated, updated and reproducible in different scenarios. The aim of this study was the early identification of conditioning factors to severe infectious complications in patients with febrile neutropenia that would allow taking decisions for diagnosis and treatment. Methods: We present a prospective cohort study that estimated the risk associated to clinical and paraclinical factors and the development of infectious complications in pediatric patients with febrile neutropenia induced by chemotherapy on their admission of an emergency room (ER). The clinical features analyzed were: age, type of cancer, chemotherapy regime, time between chemotherapy administration and ER admission, use of colony-stimulating factors, presence of central venous catheter, highest temperature registered, tachycardia, polypnea, hypoxemia and hypotension. The paraclinical features included were leucocyte, neutrophil and monocyte count, and C-reactive protein levels. Results: From 186 febrile neutropenia events, 101 cases reported infectious complications (54%). Clinical infection was the most frequent issue (38%). On the multivariate analysis we found that the features independently associated to infectious complication were tachycardia (OR1.07, CI95% 1.70-6.99) and highest temperature level reported in the ER (OR1.07, CI95% 1.00-1.13). Conclusions: Febrile neutropenia is the most common complication in pediatric oncological patients and it is related to life-threatening infections and high mortality rate. Risk prediction during the initial assessment in the ER is important to stratify patients and offer target therapy to decrease complications and prolonged hospitalization.

e19004 Background: Children cancer represents the first cause of mortality by disease worldwide. Early mortality is defined as death within the first four weeks since the patient’s admission to the hospital, and it is an indicator to evaluate attention quality. It is considered that early mortality rate must be less than 5% in acute lymphoblastic leukemias, although it is not standardized in solid tumors. The aim of this study was to evaluate the early mortality rate in a third level pediatric center. Methods: We have conducted a retrospective analysis of oncology patient records dating from January 2012 to April 2017 diagnosed and treated in the National Institute of Pediatrics in Mexico. Patients who died in the first four weeks from diagnosis were included in our study. Clinical characteristics were analyzed with an univariate analyses using measures of central tendency for quantitative data and proportions for qualitative. We used SPSS-20 for all analyses. Results: A total of 1500 patients were diagnosed with neoplastic disease at the Institute within 2012 and 2017, 34 (2.26%) of them had an early death. Median age of diagnosis was 5 years. Central nervous system (CNS) tumors were the predominant group associated to early mortality (23.5%), followed by hepatocarcinoma, acute lymphoblastic leukemia (ALL), neuroblastoma, diffuse intrinsic pontine glioma (DIPG), and Wilms tumor (5.9% each). 70.6% had metastatic disease at diagnosis. Main cause of death was progression of disease (60%), followed by infectious complications (35%). Only one patient was treated by palliative care. Conclusions: In spite of children cancer care innovations, early death rates are still high, mainly because of delay in diagnosis at advanced stages of the disease. Another important factor in low-middle income countries is treatment abandonment, which is higher in patients who live in precarious conditions and live in isolated communities and must travel long distances to get medical attention. As healthcare professionals from a low-middle income country, we still have a lot to do to prevent our patients early mortality.