Cancer and sepsis

Abstract

Sepsis is one of the leading causes of death worldwide. While mortality is high regardless of inciting infection or comorbidities, mortality in patients with cancer and sepsis is significantly higher than mortality in patients with sepsis without cancer. Cancer patients are also significantly more likely to develop sepsis than the general population. The mechanisms underlying increased mortality in cancer and sepsis patients are multifactorial. Cancer treatment alters the host immune response and can increase susceptibility to infection. Preclinical data also suggests that cancer, in and of itself, increases mortality from sepsis with dysregulation of the adaptive immune system playing a key role. Further, preclinical data demonstrate that sepsis can alter subsequent tumor growth while tumoral immunity impacts survival from sepsis. Checkpoint inhibition is a well-accepted treatment for many types of cancer, and there is increasing evidence suggesting this may be a useful strategy in sepsis as well. However, preclinical studies of checkpoint inhibition in cancer and sepsis demonstrate results that could not have been predicted by examining either variable in isolation. As sepsis management transitions from a ‘one size fits all’ model to a more individualized approach, understanding the mechanistic impact of cancer on outcomes from sepsis represents an important strategy towards delivering on the promise of precision medicine in the intensive care unit.

Characteristics and outcomes of cancer patients admitted to intensive care units in cancer specialized hospitals in China

“…In addition, patients may be transferred due to postoperative care (Biskup et al 2017 ). It has been suggested that patients with lung cancer had a higher risk of ARF as well as bacterial infection (Cupp et al 2018 ; Williams et al 2023 ). It is not surprising since the lung is the main respiratory organ, more accessible to environmental pathogens, as well as plays a critical role in the immune system (Kumar 2020 ).…”

Procalcitonin and interleukin-6 in predicting prognosis of sepsis patients with cancer

“…In ammatory reactions play a signi cant role in the progression of sepsis [10].Due to the differences in immune cell function, in ammatory in ltration, and other aspects, laboratory testing range for various infection indicators in tumor patients with sepsis may not be consistent with those in non-tumor patients [11,12].Therefore, we evaluated early warning effectiveness of sepsis in cancer patients by collecting and observing changes in infection indicators at different time points, In evaluation of early warning indicators for sepsis, both visual observations of heat maps and data indicated that PCT and IL-6 levels in sepsis patients were higher than those in non-sepsis patients, while the difference in WBC and CRP between two groups was not signi cant. Initial values of PCT and IL-6 in sepsis patients showed signi cant changes compared to non-sepsis patients, indicating that both PCT and IL-6 indicators might predict sepsis in patient.For a single indicator, initial value of PCT, as an infection indicator for early sepsis warning, had the highest AUC, and its optimal cut-off valuewas 0.765 ng/mL, followed by SOFA score.…”

Optimizing Blood Culture Collection Volumes

“…In the immunocompromised oncology patient population, rapid identification and treatment of infection before the onset of sepsis saves lives. People with cancer are more likely than the general population to develop sepsis and have a significantly higher risk of mortality from sepsis 1. Immediate nursing intervention, which includes the proper collection of blood culture specimens, impacts overall survival from infection.…”