Mortality of cancer patients with septic shock: A nation-based cohort analysis of 77,888 patients

Background

Septic shock and cancer occur routinely in intensive care unit patients. Our aim was to use the French national hospitalization database to overcome the limitations of the small cohorts used in previous studies that examined the 90-day mortality rate of patients with septic shock and either solid or hematological cancers.

Methods

We performed a retrospective cohort study using data from the French national hospitalization database regarding adult patients with septic shock from 2017 to 2018. The primary outcomes were the hospital mortality rate at 90 days in patients with solid cancer and hematological cancer. Secondary outcomes were the risk factors associated with mortality in our cohort. Associations between 90-day mortality and cancer have been estimated by multivariable analysis.

Results

Septic shock was found in 77,888 patients, including 19,329 patients with solid cancer, 6,498 with hematological cancer, and 52,061 noncancer patients. The 90-day mortality rate was 44.3 %, 53.7%, and 59.1% for noncancer patients, solid cancer patients and hematological cancer patients, respectively. An association was found between 90-day mortality and solid cancer (adjusted hazard ratio 1.55 [1.51–1.59]) or hematological cancer (1.59 [1.53–1.65]) as compared with noncancer patients. Risk factors for 90-day mortality included both hematological and solid cancers.

Conclusions

In septic shock patients, solid cancer and hematological cancer were associated with increased 90-day mortality compared with noncancer patients. Future investigations are required to assess the interplay between cancer and septic shock.

Registration

National Commission for Data Protection (CNIL) under number F20220318151239