Factors Associated With Death at 30 Days and Evaluation of Clinical Risk Scores Among Patients With Cancer Admitted With Postchemotherapy Infection in Uganda: A Prospective Cohort Study.
Ambaru Jacinta Ojia, Sophie E Lyon, Jane Francis Birungi, Catherine Owomugisha, Rose Muhindo, Semei Buwambaza Sekitene, Christopher C Moore, Edwin Nuwagira
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引用次数: 0
Abstract
Background: Little is known about outcomes from cancer chemotherapy--associated infections in sub-Saharan Africa. Accordingly, among patients with cancer admitted with postchemotherapy infection in Mbarara, Uganda, we aimed to determine (1) the 30-day case fatality rate, (2) factors associated with mortality rate, and (3) clinical risk score performance.
Methods: We enrolled participants aged ≥18 years if they (1) received cancer chemotherapy within the past 30 days, (2) were admitted to the oncology ward, and (3) were prescribed intravenous antibiotics. We used Cox proportional hazards regression to determine predictors of death at 30 days and calculated the area under the receiver operating characteristic curve (AUC) for each clinical risk score.
Results: Among 150 participants, 67 (45%) were female, and the median (interquartile range) age was 56 (43-66) years. Esophageal cancer (18%) and pneumonia (42%) were the most common cancer and infection, respectively. Death occurred within 30 days in 63 participants (42%). Quick Sequential Organ Failure Assessment (qSOFA) score ≥2 (adjusted hazard ratio, 2.51 [95% confidence interval, 1.42-4.44]; P = .001), and Universal Vital Assessment (UVA) score >4 (2.13 [.08-4.18, P = .03) were independently associated with death at 30 days. An Eastern Cooperative Oncology Group (ECOG) score ≥3 was similarly independently associated with death at 30 days in the qSOFA and UVA models. The AUCs for qSOFA and UVA scores were 0.70 (95% confidence interval, .63-.79) and 0.72 (.64-.80), respectively.
Conclusions: In participants with postchemotherapy infection in Mbarara, Uganda, the case fatality rate was high. ECOG, qSOFA, and UVA scores were associated with death at 30 days.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.