Association between site of infection and mortality in patients with cancer with sepsis or septic shock: A retrospective cohort study

Abstract

Infections are associated with increased mortality in patients with sepsis or septic shock. However, to the best of our knowledge, the influence of the site of infection on patients with cancer remains unclear. The present study aimed to evaluate the association between the site of infection and mortality in patients with cancer and sepsis or septic shock. The present study was conducted in a Lebanon tertiary care centre from July 2010 to April 2015. A total of 176 patients with active cancer presenting to the emergency department with sepsis or sepsis shock were included in the present analysis. Cox regression and Kaplan-Meier analysis of the effect of the site of infection on mortality were performed. The most common site of infection was the lung (37.50%), followed by the urinary tract (26.70%), unknown site (13.63%), gastrointestinal (13.07%) and others (9.10%). The overall mortality rate was 47.73%. Gastrointestinal infection (78.26%) was associated with the highest mortality, followed by pneumonia (62.12%). The urinary tract infection with the lowest mortality rate was the reference group. After adjusting for confounding variables, gastrointestinal infection was associated with the highest in-hospital mortality [hazard ratio (HR), 2.64; 95% CI, 1.25-5.55], followed by pneumonia (HR, 1.95; 95% CI, 1. 03-3.68). The association between site of infection and 28-day and 60-day mortality was analysed by Cox regression, as well as by stratified analysis to investigate the association between site of infection and mortality from haematological and solid tumors. Gastrointestinal infection had a higher mortality rate. In conclusion, the site of infection had the same association with mortality in patients with solid and haematological tumours.

An Individualized Nomogram for Predicting Mortality Risk of Septic Shock Patients During Hospitalization: A ten Years Retrospective Analysis

“…32 Although several studies have reported the close relationship between the infection origin and prognosis in sepsis patients, different patient inclusion criteria and comorbidities would have non-negligible impact on the observed endpoint event. [32][33][34][35][36] In this study, the infection site was not associated with mortality, which could be partly explained by the late disease status of involved patients (septic shock) in this study other than the early status in previous data (sepsis). 37,38 Many scoring tools to evaluate the prognosis of patients with sepsis or septic shock, such as SOFA, qSOFA, and SIRS standard, exist.…”