Luc Te Marvelde1,2, Ann Whitfield3, Jennie Shepheard4, Carla Read4, Roger L Milne1,5, Kathryn Whitfield2. 1. Cancer Epidemiology Division, Cancer Council Victoria. 2. Cancer Strategy & Development, Department of Health and Human Services, Victoria. 3. Retired. 4. Information Management and Standards, Victorian Agency for Health Information, Victoria. 5. Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Victoria.
Abstract
OBJECTIVE: To determine the clinical characteristics, outcomes and longitudinal trends of sepsis occurring in cancer patients. METHOD: Retrospective study using statewide Victorian Cancer Registry data linked to various administrative datasets. RESULTS: Among 215,763 incident cancer patients, incidence of sepsis within one year of cancer diagnosis was estimated at 6.4%. The incidence of sepsis was higher in men, younger patients, patients diagnosed with haematological malignancies and those with de novo metastatic disease. Of the 13,316 patients with a first admission with sepsis, 55% had one or more organ failures, 29% required care within an intensive care unit and 13% required mechanical ventilation. Treatments associated with the highest sepsis incidence were stem cell/bone marrow transplant (33%), major surgery (4.4%), chemotherapy (1.1%) and radical radiotherapy (0.6%). The incidence of sepsis with organ failure increased between 2008 and 2015, while 90-day mortality decreased. CONCLUSIONS: Sepsis in patients with cancer has high mortality and occurs most frequently in the first year after cancer diagnosis. Implications for public health: The number of cancer patients diagnosed with sepsis is expected to increase, causing a substantial burden on patients and the healthcare system.
OBJECTIVE: To determine the clinical characteristics, outcomes and longitudinal trends of sepsis occurring in cancerpatients. METHOD: Retrospective study using statewide Victorian Cancer Registry data linked to various administrative datasets. RESULTS: Among 215,763 incident cancerpatients, incidence of sepsis within one year of cancer diagnosis was estimated at 6.4%. The incidence of sepsis was higher in men, younger patients, patients diagnosed with haematological malignancies and those with de novo metastatic disease. Of the 13,316 patients with a first admission with sepsis, 55% had one or more organ failures, 29% required care within an intensive care unit and 13% required mechanical ventilation. Treatments associated with the highest sepsis incidence were stem cell/bone marrow transplant (33%), major surgery (4.4%), chemotherapy (1.1%) and radical radiotherapy (0.6%). The incidence of sepsis with organ failure increased between 2008 and 2015, while 90-day mortality decreased. CONCLUSIONS:Sepsis in patients with cancer has high mortality and occurs most frequently in the first year after cancer diagnosis. Implications for public health: The number of cancerpatients diagnosed with sepsis is expected to increase, causing a substantial burden on patients and the healthcare system.
Authors: Bernardo L Rapoport; Helen C Steel; Nomsa Hlatshwayo; Annette J Theron; Pieter W A Meyer; Simon Nayler; Carol-Ann Benn; Teresa Smit; Luyanda L I Kwofie; Liezl Heyman; Ronald Anderson Journal: Front Immunol Date: 2022-05-23 Impact factor: 8.786
Authors: Ching-Wen Chen; Kelsey B Bennion; David A Swift; Kristen N Morrow; Wenxiao Zhang; Takehiko Oami; Craig M Coopersmith; Mandy L Ford Journal: J Immunol Date: 2021-04-28 Impact factor: 5.422