Past history of stage I/II solid tumor malignancy impacts considerably on sepsis mortality: a propensity score matching analysis from the hellenic sepsis study group

George Dimοpoulos,Miltiades Kyprianou,Dimitrios Konstantonis,Glykeria Vlachogianni,Evangelos J Giamarellos-Bourboulis,Konstantina Vryza,Maria Patrani,Christina Routsi,Eleni Antoniadou,Nikoletta Rovina

doi:10.1186/s12879-019-4448-7

George Dimοpoulos, Miltiades Kyprianou + Show 8 more

Open Access

https://doi.org/10.1186/s12879-019-4448-7

Copy DOI

Abstract

BackgroundWhether past history of solid stage I/II inactive cancer has an impact on 28-day mortality of sepsis remains unclear. We aimed to determine the impact of history of stage I or II solid tumor malignancy in complete remission the last 3 years on sepsis outcome.MethodsUsing the database of the Hellenic Sepsis Study Group from 1553 patients with sepsis admitted in the ICU, 83 patients with sepsis by Sepsis-3 definition with past-history of stage I/II inactive solid malignancy the last 3 years were depicted. A comparator group of 83 patients fully matched for age, severity, type of infection and comorbidities was selected by propensity score matching.ResultsMortality after 28 days was 37.3% in the comparator group and 54.2% in the solid tumor stage I/II group (odds ratio for death 1.98; p: 0.030). Following step-wise forward Cox regression analysis, septic shock (hazard ratio 1.80), acute renal injury (hazard ratio 2.06), history of coronary heart disease (hazard ratio 0.36) and history of stage I/II solid tumor malignancy (hazard ratio 1.79) were the only independent variables associated with 28-day mortality. Serum levels of procalcitonin and of soluble urokinase plasminogen activator receptor were similar between the two groups of comparisons.ConclusionsPast history of stage I/II solid malignancy is an independent risk factor for unfavorable outcome from sepsis the first 28 days.

Highlights

Whether past history of solid stage I/II inactive cancer has an impact on 28-day mortality of sepsis remains unclear
It is largely conceived that cancer patients are more prone to sepsis and unfavorable outcome due to factors associated with their malignancies like chemotherapyinduced immunosuppression and metastasis-associated organ obstructions [7]
In order to reply to this question, we used the database of the Hellenic Sepsis Study Group (HSSG) that includes a broad collection of clinical data from both non-Intensive Care Unit (ICU) and ICU patients with sepsis

Summary

Introduction

Whether past history of solid stage I/II inactive cancer has an impact on 28-day mortality of sepsis remains unclear. We aimed to determine the impact of history of stage I or II solid tumor malignancy in complete remission the last 3 years on sepsis outcome. Dimοpoulos et al BMC Infectious Diseases 1(209): for ICU admission of cancer patients following postoperative care [5]. No data are available if history of cancer that remains inactive may per se become a comorbidity driving towards unfavorable outcome. We aimed to analyze the impact of history of stage I or II solid tumor malignancies in complete remission the last 3 years on the 28-day mortality of patients with sepsis admitted in the ICU

Objectives

Methods

Results

Discussion

Conclusion