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

BMC Infect Dis. 2019 Oct 7;19(1):831. doi: 10.1186/s12879-019-4448-7.

Abstract

Background: 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.

Methods: Using 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.

Results: Mortality 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.

Conclusions: Past history of stage I/II solid malignancy is an independent risk factor for unfavorable outcome from sepsis the first 28 days.

Keywords: Cancer; ICU; Outcome; Severity.

MeSH terms

  • Acute Kidney Injury / complications
  • Aged
  • Aged, 80 and over
  • Coronary Disease / complications
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Neoplasm Staging*
  • Neoplasms / complications*
  • Neoplasms / pathology*
  • Odds Ratio
  • Propensity Score*
  • Proportional Hazards Models
  • Risk Factors
  • Sepsis / mortality*
  • Shock, Septic / complications