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Long-term prognosis of septic shock in cancer patients.
- Source :
-
Supportive Care in Cancer . Mar2020, Vol. 28 Issue 3, p1325-1333. 9p. - Publication Year :
- 2020
-
Abstract
- <bold>Objectives: </bold>In the last decades, the number of cancer patients admitted in intensive care units (ICUs) for septic shock has dramatically increased. However, prognosis data remain scarce.<bold>Methods: </bold>To assess the 180-day mortality rate in cancer patients admitted to the ICU for septic shock, a 5-year prospective study was performed. All adult patients admitted for septic shock were included and categorized into the following two groups and four subgroups: cancer patients (solid tumor or hematological malignancy) and non-cancer patients (immunocompromised or not). Data were collected and compared between the groups. Upon early ICU admission, the decision to forgo life-sustaining therapy (DFLST) or not was made by consultation among hematologists, oncologists, and the patients or their relatives.<bold>Results: </bold>During the study period, 496 patients were admitted for septic shock: 252 cancer patients (119 hematological malignancies and 133 solid tumors) and 244 non-cancer patients. A DFLST was made for 39% of the non-cancer patients and 52% of the cancer patients. The 180-day mortality rate among the cancer patients was 51% and 68% for those with hematological malignancies and solid cancers, respectively. The mortality rate among the non-cancer patients was 44%. In a multivariate analysis, the performance status, Charlson comorbidity index, simplified acute physiology score 2, sequential organ failure assessment score, and DFLST were independent predictors of 180-day mortality.<bold>Conclusions: </bold>Despite early admission to the ICU, the 180-day mortality rate due to septic shock was higher in cancer patients compared with non-cancer patients, due to excess mortality in the patients with solid tumors. The long-term prognosis of cancer patients with septic shock is modulated by their general state, severity of organ failure, and DFLST. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09414355
- Volume :
- 28
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Supportive Care in Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 141453752
- Full Text :
- https://doi.org/10.1007/s00520-019-04937-4