Zeynep Ture, Gülşen İskender, Md Mustafa Serhat Şahinoğlu, Md Ezel Beste Özkara, Ayşe Kaya Kalem, Esma Eryılmaz Eren, Fatma Yekta Ürkmez, Sinan Çetin, Emel Azak, İlknur Erdem, Jordi Rello, Emine Alp
{"title":"癌症患者败血症的流行病学和预后:多中心前瞻性观察研究》。","authors":"Zeynep Ture, Gülşen İskender, Md Mustafa Serhat Şahinoğlu, Md Ezel Beste Özkara, Ayşe Kaya Kalem, Esma Eryılmaz Eren, Fatma Yekta Ürkmez, Sinan Çetin, Emel Azak, İlknur Erdem, Jordi Rello, Emine Alp","doi":"10.1016/j.amjms.2025.02.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To determine the epidemiology and prognosis of sepsis in cancer patients and the influence of sepsis on the mortality of cancer patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epidemiology and Prognosis of Sepsis in Cancer Patients: A Multicenter Prospective Observational Study.\",\"authors\":\"Zeynep Ture, Gülşen İskender, Md Mustafa Serhat Şahinoğlu, Md Ezel Beste Özkara, Ayşe Kaya Kalem, Esma Eryılmaz Eren, Fatma Yekta Ürkmez, Sinan Çetin, Emel Azak, İlknur Erdem, Jordi Rello, Emine Alp\",\"doi\":\"10.1016/j.amjms.2025.02.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To determine the epidemiology and prognosis of sepsis in cancer patients and the influence of sepsis on the mortality of cancer patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":94223,\"journal\":{\"name\":\"The American journal of the medical sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The American journal of the medical sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjms.2025.02.008\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American journal of the medical sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.amjms.2025.02.008","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Epidemiology and Prognosis of Sepsis in Cancer Patients: A Multicenter Prospective Observational Study.
Objectives: To determine the epidemiology and prognosis of sepsis in cancer patients and the influence of sepsis on the mortality of cancer patients.
Methods: 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.
Results: 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).
Conclusions: 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.