Clinical characteristics and outcomes of critically ill cancer patients with septic shock

Ñamendys‐Silva, Silvio A.; González-Herrera, María O.; Texcocano‐Becerra, Julia; Herrera‐Gómez, Ángel

doi:10.1093/qjmed/hcq260

Cited by 22 publications

(16 citation statements)

References 28 publications

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“…Majority of patients in the current study could not carry on self-care and were confined to bed completely. In agreement with the other studies,8 10 36 our analysis showed that patients with poor PS (≥3) had 5.4 times more risks of mortality. IMV was needed in 62 (62%) patients at ICU admission in the form of intubation (endotracheal tube (ETT)) or tracheostomy due to ARDS.…”

Section: Discussionsupporting

confidence: 92%

“…Majority of the patients in the current study had solid tumour and these findings corroborate with previous study demonstrating increased association of solid tumour with PASS 15. Existing literature described significant relationship between septic shock at ICU admission and mortality 8 15. However, our findings are incongruous with results of previous investigations where septic shock at ICU admission was not associated (p=0.667) with mortality.…”

Section: Discussionsupporting

confidence: 81%

“…A few studies have reported that 6%–30% of patients in intensive care unit (ICU) acquire sepsis and majority of patients (more than 50%) lead to septic shock 6 7. The mortality rate ranges from 40% to 60% in patients with cancer admitted to ICU with pneumonia-associated septic shock (PASS) 4 8 9. The reason for high mortality associated with septic shock from pneumonia compared with other sites of infection is concurrent acute respiratory failure 10.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of clinical features and determinants of mortality among cancer patients with septic shock of pulmonary origin: a prospective analysis

Rasheed

Khan

Mujtaba

et al. 2019

Postgraduate Medical Journal

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BackgroundPneumonia-associated septic shock (PASS) in patients with cancer inflicts healthcare burden attributed to high morbidity and mortality. Current study was aimed to evaluate the clinical outcomes, microbiological characteristics, risk factors and impact of life-support interventions on 28-day mortality among cancer patients with PASS.MethodsA prospective observational study was conducted among cancer patients with PASS admitted to intensive care unit (ICU) of ‘Shaukat Khanum Memorial Cancer Hospital’. Data were analysed using appropriate statistical methods.ResultsOut of 100 patients who sought medical care during the study period, 59 (59%) were male and majority had solid tumour than haematological malignancies (68% vs 32%). Nosocomial pneumonia was most frequent (90%) followed by healthcare-associated pneumonia (HCAP) (9%) and community-acquired pneumonia (CAP) (1%). The most common causative pathogen was Pseudomonas aeruginosa, 21 (32%). Overall mortality rate was 76% including 15% hospital and 61% ICU mortality. Sequential Organ Failure Assessment (SOFA) score at first day (HR 3.8; 95% CI 1.7 to 8.9; p=0.002), SOFA score at seventh day (HR 8.9; 95% CI 3.6 to 22.7; p=<0.001), invasive mechanical ventilation (HR 8.0; 95% CI 3.2 to 20; p<0.001) and performance status (HR 5.4; 95% CI 2.5 to 11.3; p<0.001) were found to be independently associated with 28-day mortality. Receiver operating characteristic curve analysis accentuates the excellent predictive accuracy of Cox regression model for mortality indicated by area under the curve of 0.892 (95% CI 0.801 to 0.983, p<0.001).ConclusionOur analysis demonstrates substantial mortality associated with PASS among patients with cancer. Timely recognition of patients with high predilection of increased mortality could be of value in improving the disease burden.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Assessment of clinical features and determinants of mortality among cancer patients with septic shock of pulmonary origin: a prospective analysis

Rasheed

Khan

Mujtaba

et al. 2019

Postgraduate Medical Journal

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“…Mortality in ICU was 40% in cancer group, a number similar to that found by Ñamendys-Silva et al [26] in Mexico. In Brazil, Soares et al [18] reported a 44% of mortality rate in a cancer group admitted at ICU due to medical causes, not specifically to sepsis, which accounted only for 15% of admissions.…”

Section: Discussionsupporting

confidence: 88%

sTREM-1 predicts intensive care unit and 28-day mortality in cancer patients with severe sepsis and septic shock

Ravetti

Moura

Vieira³

et al. 2015

Journal of Critical Care

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“…Our ICU routinely implements the guidelines for management of severe sepsis and septic shock [27, 28], because they have been associated with a significant reduction in hospital mortality in patients with severe sepsis and septic shock from 37% to 30.8% ( P = 0.001) [29]. …”

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome Caused by Influenza B Virus Infection in a Patient with Diffuse Large B-Cell Lymphoma

Ñamendys‐Silva

González-Herrera

Texcocano‐Becerra

et al. 2011

Case Reports in Medicine

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Influenza B virus infections are less common than infections caused by influenza A virus in critically ill patients, but similar mortality rates have been observed for both influenza types. Pneumonia caused by influenza B virus is uncommon and has been reported in pediatric patients and previously healthy adults. Critically ill patients with pneumonia caused by influenza virus may develop acute respiratory distress syndrome. We describe the clinical course of a critically ill patient with diffuse large B-cell lymphoma nongerminal center B-cell phenotype who developed acute respiratory distress syndrome caused by influenza B virus infection. This paper emphasizes the need to suspect influenza B virus infection in critically ill immunocompromised patients with progressive deterioration of cardiopulmonary function despite treatment with antibiotics. Early initiation of neuraminidase inhibitor and the implementation of guidelines for management of severe sepsis and septic shock should be considered.

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Clinical characteristics and outcomes of critically ill cancer patients with septic shock

Abstract: The variables associated with increased mortality were the degree of organ dysfunction determined by SOFA score at ICU admission and PS≥2.

Cited by 22 publications

References 28 publications

Assessment of clinical features and determinants of mortality among cancer patients with septic shock of pulmonary origin: a prospective analysis

Assessment of clinical features and determinants of mortality among cancer patients with septic shock of pulmonary origin: a prospective analysis

sTREM-1 predicts intensive care unit and 28-day mortality in cancer patients with severe sepsis and septic shock

Acute Respiratory Distress Syndrome Caused by Influenza B Virus Infection in a Patient with Diffuse Large B-Cell Lymphoma

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