Pediatric oncology secondary diagnosis

I notice many of the pediatric oncology charts have increased length of stay.  Other than Dx. the cancer and chemo/radiation tx. pancytopenia assoc w chemo, and adverse effect of chemo.   I have discussed the importance of documenting malnutrition/obesity.  Does anyone else have any other suggestions of common secondary diagnosis in this population?  Maybe hyposplenia?  What are you seeing in your hospitals?



  • See diagnoses like the ones you listed. Also look for Tumor Lysis Syndrome. Sometimes AKI/Acute Renal Failure. Constipation due to opioid therapy (hey, if they are treating it, they should be documenting it, right?!!!)

  • edited June 2018

    I am blessed to have a really experienced dietician who not only identifies the malnutrition degree as well as the obesity/morbid obesity, but tells the resident straight out in rounds that the diagnosis must be added to the notes.  She gets it every time.  I almost never ask it, she beats me to it.  Those are big diagnoses for heme/onc/BMT kids.  There are certain chemo drugs that cause SIRS.  There are the bouts of CLABSI or sepsis from their immunocompromised state.  The BMT kids also have GVHD and my favorite- typhlitis.  No it is NOT appendicitis, but the codes think so.

    AKI with ATN is not uncommon.  Hypertension secondary to steroids. Also secondary diabetes due to those same high dose steroids.  There is neuropathic pain secondary to certain drugs like Vincristine (also big for constipation).

    Almost forgot the remission status of their leukemia and especially if they go from remission to relapse.

  • Thanks! Appreciate the feedback.
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