American Journal of the Medical Sciences最新文献

{"title":"Elevated blood anandamide levels in acute COVID-19 pneumonia with respiratory failure","authors":"Abhishek Basu PhD ,&nbsp;Lenny Pommerolle PhD ,&nbsp;Muhammad Arif PhD ,&nbsp;Angelo Y. Meliton MD ,&nbsp;Inemesit Udofia ,&nbsp;David Wu MD ,&nbsp;Gökhan M. Mutlu MD ,&nbsp;Bernadette R. Gochuico MD ,&nbsp;Ross Summer MD ,&nbsp;Ayodeji Adegunsoye MDPhD ,&nbsp;Ellen L. Burnham MD ,&nbsp;Resat Cinar PhD","doi":"10.1016/j.amjms.2025.06.003","DOIUrl":"10.1016/j.amjms.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Subsets of COVID-19 pneumonia patients with acute respiratory failure experienced long-term respiratory dysfunction and persistent radiological abnormalities. However, mechanisms contributing to persistent pulmonary dysfunction following COVID-19 remain unclear. Increased cannabinoid receptor 1 (CB₁R) expression has been reported in the lungs of patients who died from COVID-19 pneumonia. Multiple studies indicate that CB₁R overactivation exacerbates inflammation and tissue disrepair in mice, and the level of anandamide (AEA), an endogenous CB₁R agonist and endocannabinoid, is higher in the lungs of patients with pulmonary fibrosis, correlating with poor lung function. These observations suggest the potential for overactivity of the endocannabinoid/CB₁R pathway to adversely impact lung repair in COVID-19 pneumonia.</div></div><div><h3>Methods</h3><div>In this study, we sought to determine the relationship between circulating endocannabinoids and inflammatory mediators in patients with COVID-19 pneumonia from two independent cohorts in different geographic US locations. Endocannabinoid levels were measured using liquid chromatography coupled triple quadrupole mass spectrometry, while inflammatory cytokines and chemokines were measured using Luminex assay in blood serum collected at various time points during COVID-19 pneumonia.</div></div><div><h3>Results</h3><div>We found that blood serum levels of endocannabinoid AEA were significantly elevated in acute COVID-19 pneumonia patients compared to patients with non-COVID-19-associated acute respiratory failure, and healthy controls. Further, 2-arachidonyl glycerol (2AG)] was significantly elevated in acute COVID-19 pneumonia patients on par with non-COVID acute respiratory failure patients. Levels of circulating AEA and 2AG correlated with multiple inflammatory markers.</div></div><div><h3>Conclusions</h3><div>Our findings suggest increased circulating endocannabinoid tone may be involved in the pathogenesis of COVID-19 pneumonia during the acute phase of illness.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"370 3","pages":"Pages 271-277"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of novel thrombus markers in COPD with deep venous thrombosis","authors":"Jiajun Huang MS ,&nbsp;Jie Huang MS ,&nbsp;Chunli Sun PhD ,&nbsp;Feng Tian MS ,&nbsp;Jufang Wang PhD","doi":"10.1016/j.amjms.2025.06.006","DOIUrl":"10.1016/j.amjms.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>This study assesses the diagnostic value of new thrombosis markers, including thrombin antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), thrombomodulin (TM), and tissue plasminogen activator-inhibitor complex (t-PAIC), for the incidence prediction of deep venous thrombosis (DVT) of lower limb in chronic obstructive pulmonary disease (COPD) patients.</div></div><div><h3>Methods</h3><div>98 patients with COPD admitted to Shenzhen Guangming district people’s hospital from March 2020 to May 2022 and were selected and divided into a non-DVT group (<em>n</em> = 62) and a DVT (<em>n</em> = 36) group. A control group consisting of 50 healthy subjects were recruited. The blood sugar and lipid metabolic indicators of patients in each group were analyzed and compared. ROC curve analysis was performed to assess the diagnostic efficacy of new thrombosis markers.</div></div><div><h3>Results</h3><div>There were no significant differences in the levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) among the three groups. The DVT group exhibited higher levels of fibrin degradation product (FDP) and <span>D</span>-dimer (D-D) than the non-DVT group. The plasma levels of TAT, PIC, TM, and t-PAIC in the DVT group significantly elevated compared to the other two groups. Combined diagnosis of TAT and TM displayed superior diagnostic efficacy with maximum AUC values (0.833) and a sensitivity of 87.5 %.</div></div><div><h3>Conclusions</h3><div>The detection of serum levels of TAT, PIC, TM, and t-PAIC have diagnostic value in COPD patients with DVT.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"370 3","pages":"Pages 259-264"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirrhosis and hyponatremia: A review of pathogenesis, clinical relevance, and management","authors":"Jackeline Flores MD,&nbsp;Andrea Ortiz Maldonado MD,&nbsp;Camilo Pena MD,&nbsp;Kenneth Nugent MD","doi":"10.1016/j.amjms.2025.06.004","DOIUrl":"10.1016/j.amjms.2025.06.004","url":null,"abstract":"<div><div>This narrative review examines the prognostic significance of sodium levels in cirrhosis<span><span><span><span>. Clinical findings such as ascites typically develop between 5 and 10 years post-diagnosis, often with dysregulated sodium balance. About 50 % of </span>cirrhosis<span> patients develop hyponatremia, linked to poor prognosis, necessitating effective assessment and management. Hyponatremia arises from splanchnic </span></span>vasodilation<span>, causing fluid accumulation and reduced effective arterial volume, which triggers adaptive responses that worsen water retention and sodium imbalance. Ascitic fluid contains significant sodium stores, and its levels closely approximate serum values, suggesting that measuring ascitic sodium during therapeutic paracentesis<span> might reduce the need for serum sampling. Management strategies include fluid restriction, vaptans, and albumin infusions, particularly in patients with acute kidney injury<span> and ascites. Although pleural and </span></span></span></span>peritoneal fluid<span> analyses are routine, sodium levels are usually not measured despite their clinical relevance. This review addresses the pathophysiology<span><span>, clinical implications, and management of hyponatremia in cirrhosis, focusing on patients with ascites or hepatic </span>hydrothorax.</span></span></span></div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"370 3","pages":"Pages 209-216"},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular therapy in acute ischemic stroke: A six-year national assessment of utilization and outcomes","authors":"Abdul Rasheed Bahar MD ,&nbsp;Yasemin Bahar MD ,&nbsp;Syed Murtaza Ishaq MD ,&nbsp;Abubakr Ziaullah MD ,&nbsp;Prakash Upreti MD ,&nbsp;Mohamed Alrayyashi MD ,&nbsp;Olayiwola Bolaji MD ,&nbsp;M Chadi Alraies MD","doi":"10.1016/j.amjms.2025.06.005","DOIUrl":"10.1016/j.amjms.2025.06.005","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Ischemic stroke is a leading cause of death and disability worldwide. Endovascular treatment (EVT) is recognized as an effective intervention for acute ischemic stroke, but only a small fraction of patients with large vessel occlusion receive it. While EVT adoption has grown in the U.S., data on short- and long-term outcomes remain limited. This study aims to assess trends and in-hospital outcomes of stroke patients undergoing EVT.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using the Nationwide Inpatient Sample (NIS) database from 2016 to 2021. Adult patients hospitalized with LVO stroke involving the internal carotid or middle cerebral arteries were identified using ICD-10-CM codes and stratified by EVT status. Multivariable logistic regression and propensity score matching were used to adjust for baseline characteristics and evaluate in-hospital outcomes.</div></div><div><h3>Results</h3><div>Among 840,335 hospitalizations with LVO stroke, 103,355 (13.3 %) underwent EVT. In the PSM analysis of matched cohort (n=18,460), EVT was associated with higher in-hospital mortality (10.4 % vs. 5.6 %, p&lt;0.001), intracerebral hemorrhage (18.58 % vs. 9.82 %, p&lt;0.001), periprocedural stroke (0.16 % vs. 0.08 %, p=0.035), cardiac arrest (2.93 % vs. 1.37 %, p&lt;0.001), and major adverse cardiac events (13.10 % vs. 8.08 %, p&lt;0.001), acute kidney injury (15.59 % vs. 14.76 %, p=0.025) and arrhythmias (52.96 % vs. 41.40 %, p&lt;0.001). Seizure incidence was lower in the EVT group (1.87 % vs. 2.58 %, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Despite increased use of EVT, our study revealed that patients undergoing this intervention experienced higher in-hospital mortality and complication rates. These findings underscore the importance of patient selection and the need for further real-world studies to optimize EVT outcomes.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"370 4","pages":"Pages 321-327"},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis and treatments for high altitude pulmonary hypertension: An updated review","authors":"Yuying Tan MD ,&nbsp;Jie Dai MD ,&nbsp;Bi Ran MD ,&nbsp;Qingqing Su MD ,&nbsp;Fengming Luo MD ,&nbsp;Lei Chen MD","doi":"10.1016/j.amjms.2025.06.001","DOIUrl":"10.1016/j.amjms.2025.06.001","url":null,"abstract":"<div><div>High altitude pulmonary hypertension (HAPH) is a specific type of pulmonary hypertension, caused by chronic exposure to hypobaric hypoxic environment in highlands. Recently, some important studies regarding the pathogenesis and treatments for HAPH have been published. Based on these latest publications, we performed an updated review focusing on the pathogenesis and treatments for HAPH.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"370 3","pages":"Pages 285-290"},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and outcomes of atrial fibrillation patients with thrombocytopenia: Insights from the national inpatient sample","authors":"Ahmed M. Younes MD ,&nbsp;Ahmed K. Mahmoud MD ,&nbsp;Ibrahim Kamel MD ,&nbsp;Ahmed Maraey MD ,&nbsp;Mahmoud Khalil MD","doi":"10.1016/j.amjms.2025.05.008","DOIUrl":"10.1016/j.amjms.2025.05.008","url":null,"abstract":"<div><h3>Background</h3><div><span>Anticoagulation<span> may be indicated for the management of atrial fibrillation (AF) to mitigate </span></span>thromboembolic<span> risk. Thrombocytopenia in patients with AF may influence clinical outcomes. This study aims to evaluate the impact of thrombocytopenia on inpatient outcomes in AF patients.</span></div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample (NIS) (2016-2020), patients with AF were identified using the appropriate ICD-10 codes. Outcomes were compared between patients with and without thrombocytopenia. Logistic and linear regression analyses<span><span> were performed after adjusting for possible confounders. The primary outcome was all-cause inpatient mortality. Secondary outcomes included trends of thrombocytopenia prevalence and mortality in AF patients, major bleeding, </span>hypovolemic shock, packed red blood cell (pRBC) transfusion, ischemic cerebrovascular accident, length of stay, and total charges.</span></div></div><div><h3>Results</h3><div>A total of 2,016,244 adult patients with AF were identified with 75,545 (3.8 %) having thrombocytopenia. Thrombocytopenia was associated with increased mortality (adjusted odds ratio [aOR] 2.59, 95 % confidence interval [CI] 2.31-2.89, P &lt; 0.001), major bleeding (aOR 2.15, 95 % CI 1.95-2.37, P &lt; 0.001), hypovolemic shock (aOR 3.44, 95 % CI 2.53-4.66, P &lt; 0.001), pRBC transfusion (aOR 3.43, 95 % CI 3.12-3.76, P &lt; 0.001), length of stay (adjusted mean difference [aMD] 1.60 days, 95 % CI 1.51 - 1.69, P &lt; 0.001), and total charges (aMD $17,895, 95 % CI 16,194-19,595, P &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Thrombocytopenia is associated with significantly increased mortality, bleeding complications, and resource utilization in patients with AF. These findings highlight the importance of careful management of AF in this population.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"370 4","pages":"Pages 353-357"},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ScreenDx, an artificial intelligence-based algorithm for the incidental detection of pulmonary fibrosis","authors":"Nikolas Touloumes DO ,&nbsp;Georgia Gagianas DO ,&nbsp;James Bradley MD ,&nbsp;Michael Muelly MD ,&nbsp;Angad Kalra MS ,&nbsp;Joshua Reicher MD","doi":"10.1016/j.amjms.2025.02.011","DOIUrl":"10.1016/j.amjms.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Nonspecific symptoms and variability in radiographic reporting patterns contribute to a diagnostic delay of the diagnosis of pulmonary fibrosis. An attractive solution is the use of machine-learning algorithms to screen for radiographic features suggestive of pulmonary fibrosis. Thus, we developed and validated a machine learning classifier algorithm (ScreenDx) to screen computed tomography imaging and identify incidental cases of pulmonary fibrosis.</div></div><div><h3>Methods</h3><div>ScreenDx is a deep learning convolutional neural network that was developed from a multi-source dataset (cohort A) of 3,658 cases of normal and abnormal CT's, including CT's from patients with COPD, emphysema, and community-acquired pneumonia. Cohort B, a US-based cohort (n = 381) was used for tuning the algorithm, and external validation was performed on cohort C (n = 683), a separate international dataset.</div></div><div><h3>Results</h3><div>At the optimal threshold, the sensitivity and specificity for detection of pulmonary fibrosis in cohort B was 0.91 (95 % CI 88–94 %) and 0.95 (95 % CI 93–97 %), respectively, with AUC 0.98. In the external validation dataset (cohort C), the sensitivity and specificity were 1.0 (95 % 99.9–100.0) and 0.98 (95 % CI 97.9–99.6), respectively, with AUC 0.997. There were no significant differences in the ability of ScreenDx to identify pulmonary fibrosis based on CT manufacturer (Phillips, Toshiba, GE Healthcare, or Siemens) or slice thickness (2 mm vs 2–4 mm vs 4 mm).</div></div><div><h3>Conclusion</h3><div>Regardless of CT manufacturer or slice thickness, ScreenDx demonstrated high performance across two, multi-site datasets for identifying incidental cases of pulmonary fibrosis. This suggest that the algorithm may be generalizable across patient populations and different healthcare systems.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"369 6","pages":"Pages 705-711"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AC074117.1/miR-193a-3p axis regulates the malignant progression of uterine corpus endometrial carcinoma via the m6A-related gene ALKBH5","authors":"Zhuyun Ding M.Sc ,&nbsp;Lirong Fu M.Sc ,&nbsp;Qian Zhu M.Sc ,&nbsp;Shu Bian B.Sc ,&nbsp;Min Cui B.Sc ,&nbsp;Yan Li Ph.D ,&nbsp;Xiaoyan Ying Ph.D","doi":"10.1016/j.amjms.2025.03.002","DOIUrl":"10.1016/j.amjms.2025.03.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Uterine corpus endometrial carcinoma (UCEC) is one of the most common gynecological malignancies, with an annually increasing incidence and a poor prognosis. lncRNAs and microRNAs regulate the progression of UCEC through ceRNA networks. Additionally, m6A modification plays various roles in UCEC, and abnormal regulation of it can directly affect tumor progression. However, the role of m6A-associated ceRNA networks in UCEC remains unclear.</div></div><div><h3>Methods</h3><div>Bioinformatics methods were used to construct the ceRNA regulatory network of m6A related genes in UCEC. MeRIP assays, dual-luciferase reporter assays and other experiments were used to prove the conclusions.</div></div><div><h3>Results</h3><div>This study showed that the AC074117.1/miR-193a-3p axis promoted the malignant progression of UCEC through ALKBH5, an m6A demethylase. MeRIP assay indicated that ALKBH5 regulated m6A modification in UCEC. Gene set enrichment analysis and cell proliferation and migration assays showed that the AC074117.1/miR-193a-3p/ALKBH5 axis regulated the proliferation and migration of UCEC cells. With regard to mechanistic analysis, dual-luciferase reporter assay demonstrated that AC074117.1 acted as a ceRNA for miR-193a-3p, influencing the expression of ALKBH5. Furthermore, rescue experiments validated that the regulatory effects of miR-193a-3p on the malignant progression of UCEC relied on ALKBH5 to some extent.</div></div><div><h3>Conclusions</h3><div>Altogether, this study revealed an m6A-related ceRNA network in UCEC, which may serve as a target for early diagnosis and treatment.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"369 6","pages":"Pages 726-738"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of inpatient work-up of incidental anemia during hospitalization for an acute medical condition: A retrospective cohort study","authors":"Genady Drozdinsky MD ,&nbsp;Erez Halperin MD ,&nbsp;Shiri Kushnir Bsc, MBA ,&nbsp;Yaron Rudman MD ,&nbsp;Anat Gafter-Gvili MD","doi":"10.1016/j.amjms.2025.02.009","DOIUrl":"10.1016/j.amjms.2025.02.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The best timing for evaluation of anemia is not well defined and the clinical yield of performing workup during non-anemia-related hospitalization is unclear. We aimed to evaluate the prognostic value of inpatient laboratory anemia evaluation.</div></div><div><h3>Methods</h3><div>This was a retrospective propensity-matched cohort study between the years 2013–2022 in Rabin Medical Center Israel. We included all patients admitted for non-anemia-related reasons and were found to be anemic. Patients were divided into groups based on basic laboratory anemia evaluation. Outcomes were cancer diagnosis, colonoscopy rate, duration of admission, and all-cause mortality. Multivariable analysis with competing risk of death was performed and a p-value of 5 % was considered significant.</div></div><div><h3>Results</h3><div>Following matching, 4,238 patients were included in the evaluation group compared to 7,680 in the no-evaluation group. In-patient laboratory anemia evaluation was associated with gastrointestinal cancer and any cancer diagnosis - HR of 1.53 (95 % CI, 1.15- 2.05) and HR of 1.23 (95 % CI, 1.11–1.37) respectively. The rate of colonoscopy was higher, and anemia prevalence was lower in the evaluation group after 1-year follow-up. Intravenous iron treatment was more prevalent in the evaluation group. The laboratory anemia evaluation prolonged the admission (5 vs 4 days). There was no difference in the all-cause mortality across the 10-year follow-up.</div></div><div><h3>Conclusion</h3><div>Inpatient anemia evaluation with basic laboratory tests was found to be associated with an increase in outpatient gastrointestinal cancer diagnosis and showed clinical and diagnostic advantages. For patients who can benefit from early gastrointestinal cancer diagnosis, admission holds a valid opportunity to initiate the evaluation.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"369 6","pages":"Pages 712-718"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and prognosis of sepsis in cancer patients: A multicenter prospective observational study","authors":"Zeynep Ture Assoc. Prof. Dr. ,&nbsp;Gülşen İskender Assoc. Prof. Dr. ,&nbsp;Mustafa Serhat Şahinoğlu MD ,&nbsp;Ezel Beste Özkara MD ,&nbsp;Ayşe Kaya Kalem Assoc. Prof. Dr. ,&nbsp;Esma Eryılmaz Eren Assoc. Prof. Dr. ,&nbsp;Fatma Yekta Ürkmez Assoc. Prof. Dr. ,&nbsp;Sinan Çetin Assoc. Prof. Dr. ,&nbsp;Emel Azak Assoc. Prof. Dr. ,&nbsp;İlknur Erdem Prof. Dr. ,&nbsp;Jordi Rello Prof. Dr. ,&nbsp;Emine Alp Prof. Dr. ,&nbsp;The following are the members of EPSCAP (Epidemiology and Prognosis of Sepsis in Cancer Patients) Study Group","doi":"10.1016/j.amjms.2025.02.008","DOIUrl":"10.1016/j.amjms.2025.02.008","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the epidemiology and prognosis of sepsis in cancer patients and the influence of sepsis on the mortality of cancer patients.</div></div><div><h3>Methods</h3><div>In this multicenter, prospective, observational study, cancer patients hospitalized without sepsis followed up until discharge or a maximum of 90 days were included. The incidence of sepsis in the follow-up period, risk factors for sepsis, risk factors for 28-day mortality in patients with sepsis and 90-day mortality in the entire group were determined.</div></div><div><h3>Results</h3><div>During the study, 790 cancer patients were included. Sepsis developed in 72 patients (9.1 %) during the follow-up. Older age, hospitalization due to any infection, graft versus host diseases (GVHD), the presence of a urethral catheter, and previous bacterial infection in the last three months were risk factors of sepsis. Among all cancer patients, sepsis was found to be the most important factor influencing 90-day mortality (OR 13.42(1.79–6.83)). Mortality among the sepsis cohort was independently associated with an infection with a carbapenem-resistant bacterium (OR 15.47(1.45–64.17)), appropriateness of empirical treatment (OR 5.02 (0.17–7.61)) and having a clinical improvement on the fifth day of the treatment (OR 10.58(0.39–28.25)).</div></div><div><h3>Conclusions</h3><div>Sepsis was documented in one out of 11 hospitalized cancer patients and the mortality rate increases 13-fold when sepsis develops. Invasive devices, GVHD, and previous bacterial infections were related to sepsis and antibiotic resistance were the most important driver for mortality. Antimicrobial stewardship, rational use of catheters (if necessary, in accordance with asepsis/antisepsis, short-term use) is important to save lives in cancer patients.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"369 6","pages":"Pages 679-688"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}