Abstract
This study aimed to develop a new prognostic model for predicting 30-day mortality in solid tumor patients with suspected infection. This study is a retrospective cohort study and was conducted from August 2019 to December 2019 at a single center. Adult active solid tumor patients with suspected infection were enrolled among visitors to the emergency room (ER). Logistic regression analysis was used to identify potential predictors for a new model. A total of 899 patients were included; 450 in the development cohort and 449 in the validation cohort. Six independent variables predicted 30-day mortality: Eastern Cooperative Oncology Group (ECOG) performance status (PS), peripheral oxygen saturation (SpO2), creatinine, bilirubin, C-reactive protein (CRP), and lactate. The C-statistic of the new scoring system was 0.799 in the development cohort and 0.793 in the validation cohort. The C-statistics in the development cohort was significantly higher than those of SOFA [0.723 (95% CI: 0.663–0.783)], qSOFA [0.596 (95% CI: 0.537–0.655)], and SIRS [0.547 (95% CI: 0.483–0.612)]. The discriminative capability of the new cancer-specific risk scoring system was good in solid tumor patients with suspected infection. The new scoring model was superior to SOFA, qSOFA, and SIRS in predicting mortality.
Highlights
This study aimed to develop a new prognostic model for predicting 30-day mortality in solid tumor patients with suspected infection
A total of 899 patients were included in the study: 450 in the development cohort and 449 in the validation cohort
There was a significant difference in the 30-day mortality rate between development and validation cohorts (19.3% and 25.6%, P = 0.024)
Summary
This study aimed to develop a new prognostic model for predicting 30-day mortality in solid tumor patients with suspected infection. In a recent cohort study of 1 million sepsis hospitalizations in the United States, one in five cases was associated with malignancy, and inhospital mortality was higher in cancer-related sepsis hospitalizations (27.9% vs 19.5% in non-cancer-related sepsis)[1] The vulnerability of these patients to infection is driven by many factors, including their immunocompromised state caused by anti-cancer treatments, frequent use of broad-spectrum antibiotics, and indwelling catheters[2,3]. Inflammatory markers can be elevated in both infectious and non-infectious patients with cancer[5] Organ dysfunction indicators such as elevated levels of creatinine or bilirubin, confused mentality, or respiratory distress are often chronically held in patients with cancer regardless of infection. Such altered and inconstant clinical features can lead to an inaccurate understanding of the severity of the patient’s condition and poor outcomes. This study aimed to develop a new scoring system for predicting mortality in cancer patients with suspected infection
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