Objective: Most sepsis studies have looked at the general population. The aim of this study is to report on the characteristics, treatment and hospital mortality of cancer patients diagnosed with sepsis or septic shock. Setting: Single center retrospective study at a tertiary care center looking at cancer patients who presented to our tertiary hospital in sepsis, septic shock or bacteremia between 2010 and 2015.
Participants: 176 patients with cancer were compared to 176 cancer-free controls. Primary and secondary outcomes: The primary outcome of this study was the in-hospital mortality in both cohorts. Secondary outcomes included patient demographics, ED vital signs, and parameters of resuscitation along with laboratory work. Results: A total of 352 patients were analyzed. The mean age at presentation for the cancer group was 65.4 39 ± 15.04 years, whereas the mean age for the control group was 74.68 ± 14.04 years (p<0.001). In the cancer cohort having the respiratory system was the most common site of infection (37.5%) followed by the urinary system (26.7%), while in the cancer-free arm, the urinary system was the most common site of infection (40.9%). IV fluid replacement for the first 24 hours, was higher in the cancer cohort. ED, ICU and GPU LOS were comparable in the 2 groups. 95 (54%) cancer patients died compared to 75 (42.6%) in the cancer-free group. The 28-day hospital mortality in the cancer cohort was 87 (49.4%) versus 46(26.1%) in the cancer-free cohort (p=0.009). Cancer patients had a 2.320 (CI 95% 1.225-4.395 p=0.010) odds of dying compared to non-cancer patients in the setting of sepsis. Conclusion: This is the first study looking at an in-depth analysis of sepsis in the specific oncology population. Despite aggressive care, cancer patients have higher hospital mortality than their cancer-free counterparts while adjusting for all other variables.
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