Data from: Are cancer patients with sepsis and bacteraemia at a higher risk of mortality? A retrospective chart review of patients presenting to a tertiary care centre in Lebanon

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.研究目的：现有多数脓毒症相关研究均聚焦于普通人群。本研究旨在分析罹患脓毒症或感染性休克的癌症患者的临床特征、治疗方案及住院病死率。 研究场景：本研究为单中心回顾性研究，纳入2010年至2015年间于本三级医疗中心就诊的脓毒症、感染性休克或菌血症癌症患者。 研究对象：将176例癌症患者与176例无癌对照人群进行配对比较。 主要与次要结局指标：本研究的主要结局指标为两组队列的住院病死率。次要结局指标包括患者人口学特征、急诊（Emergency Department，ED）生命体征、复苏相关参数及实验室检测指标。 研究结果：本研究共纳入352例患者进行分析。癌症组患者就诊时的平均年龄为65.4±15.04岁，无癌对照组的平均年龄为74.68±14.04岁（p<0.001）。癌症队列中最常见的感染部位为呼吸系统（37.5%），其次为泌尿系统（26.7%）；而无癌对照人群中最常见的感染部位为泌尿系统（40.9%）。癌症组患者前24小时的静脉补液量更高。两组患者的急诊、重症监护病房（Intensive Care Unit，ICU）及GPU住院时长（Length of Stay，LOS）无显著差异。癌症组中有95例（54%）患者死亡，无癌对照组为75例（42.6%）。癌症队列的28天住院病死率为87例（49.4%），无癌队列则为46例（26.1%，p=0.009）。与非癌症患者相比，脓毒症背景下癌症患者的死亡比值为2.320（95%置信区间1.225~4.395，p=0.010）。 研究结论：本研究为首项针对特定肿瘤人群脓毒症的深入分析研究。尽管接受了积极的治疗，在校正所有其他变量后，癌症患者的住院病死率仍显著高于无癌对照人群。