Data from: Are patients with cancer 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 patients with cancer diagnosed with sepsis or septic shock. Setting: A single-centre retrospective study at a tertiary care centre looking at patients with cancer who presented to our tertiary hospital with sepsis, septic shock or bacteraemia between 2010 and 2015. Participants: 176 patients with cancer were compared with 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, emergency department (ED) vital signs and parameters of resuscitation along with laboratory work. Results: A total of 352 patients were analysed. The mean age at presentation for the cancer group was 65.39±15.04 years, whereas the mean age for the control group was 74.68±14.04 years (p<0.001). In the cancer cohort 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%). intravenous fluid replacement for the first 24 hours was higher in the cancer cohort. ED, intensive care unit and general practice unit length of stay were comparable in both the groups. 95 (54%) patients with cancer died compared with 75 (42.6%) in the cancer-free group. The 28-day hospital mortality in the cancer cohort was 87 (49.4%) vs 46 (26.1%) in the cancer-free cohort (p=0.009). Patients with cancer had a 2.320 (CI 95% 1.225 to 4.395, p=0.010) odds of dying compared with patients without cancer in the setting of sepsis. Conclusions: This is the first study looking at an in-depth analysis of sepsis in the specific oncology population. Despite aggressive care, patients with cancer 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（sepsis）相关研究均聚焦于普通人群。本研究旨在分析确诊为脓毒症或感染性休克（septic shock）的肿瘤患者的临床特征、治疗方案及住院病死率。
研究设计：本研究为单中心回顾性研究（retrospective study），纳入2010年至2015年间于本三级医疗中心（tertiary care centre）就诊的脓毒症、感染性休克或菌血症（bacteraemia）肿瘤患者。
研究对象：本研究纳入176例肿瘤患者，并匹配176例无肿瘤的对照人群。
主要与次要结局指标：本研究的主要结局指标为两组受试者的住院病死率。次要结局指标包括患者人口统计学特征、急诊科（Emergency Department, ED）生命体征与复苏相关参数，以及实验室检验结果。
研究结果：本研究共纳入352例患者进行分析。肿瘤组患者就诊时的平均年龄为65.39±15.04岁，对照组患者的平均年龄为74.68±14.04岁（p<0.001）。肿瘤组最常见的感染部位为呼吸系统（37.5%），其次为泌尿系统（26.7%）；而无肿瘤对照组最常见的感染部位为泌尿系统（40.9%）。肿瘤组患者前24小时的静脉补液（intravenous fluid replacement）量更高。两组患者的急诊科、重症监护病房（Intensive Care Unit, ICU）及普通病房住院时长无显著差异。肿瘤组共有95例（54%）患者死亡，无肿瘤对照组为75例（42.6%）。肿瘤组患者的28天住院病死率为87例（49.4%），无肿瘤对照组为46例（26.1%，p=0.009）。在校正所有其他混杂变量后，脓毒症背景下的肿瘤患者死亡优势比为2.320（95%置信区间：1.225~4.395，p=0.010）。
研究结论：本研究为首项针对肿瘤人群脓毒症开展深度分析的研究。尽管接受了积极的治疗，肿瘤患者的住院病死率仍显著高于无肿瘤的对照人群。