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Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers

OBJECTIVE: To identify the incidence and clinical course of septic shock combined with neutropenia during chemotherapy in gynecological cancer patients. METHODS: We retrospectively reviewed the medical records of all gynecological cancer patients who received intravenous chemotherapy between March 2...

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Autores principales: Yoo, Jigeun, Jung, Yuyeon, Ahn, Jung Hwan, Choi, Youn Jin, Lee, Keun Ho, Hur, Sooyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440980/
https://www.ncbi.nlm.nih.gov/pubmed/32808493
http://dx.doi.org/10.3802/jgo.2020.31.e62
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author Yoo, Jigeun
Jung, Yuyeon
Ahn, Jung Hwan
Choi, Youn Jin
Lee, Keun Ho
Hur, Sooyoung
author_facet Yoo, Jigeun
Jung, Yuyeon
Ahn, Jung Hwan
Choi, Youn Jin
Lee, Keun Ho
Hur, Sooyoung
author_sort Yoo, Jigeun
collection PubMed
description OBJECTIVE: To identify the incidence and clinical course of septic shock combined with neutropenia during chemotherapy in gynecological cancer patients. METHODS: We retrospectively reviewed the medical records of all gynecological cancer patients who received intravenous chemotherapy between March 2009 and March 2018. Patients diagnosed with neutropenic septic shock (NSS) during the course of chemotherapy were identified. We calculated the overall incidence and mortality rate of NSS, and analyzed risk factors and clinical course. RESULTS: A total of 1,009 patients received 10,239 cycles of chemotherapy during the study period. Among these, 30 (3.0%) patients had 32 NSS events, of which 12 (1.2%) died. With respect to patient age during the first course of chemotherapy, the incidence of NSS after the age of 50 was significantly higher than that in patients under 50 (3.9% vs. 1.4%, p=0.034). As the number of chemotherapy courses increased, the incidence of NSS increased, and linear-by-linear association analysis showed a positive correlation (p=0.004). NSS events occurred on average 7.8 days after the last cycle of chemotherapy, and the median duration of vasopressor administration was 23.3 hours. The median age (64.0 vs. 56.5, p=0.017) and peak heart rate (149.5 min(−1) vs. 123.5 min(−1), p=0.015) were significantly higher in the group of patients who subsequently died of NSS than in those who survived. CONCLUSION: The overall incidence of NSS in gynecological cancer patients receiving chemotherapy was 3.0%, which is higher than previously estimated. Peak heart rate during NSS events may be an indicator for predicting survival.
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spelling pubmed-74409802020-09-01 Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers Yoo, Jigeun Jung, Yuyeon Ahn, Jung Hwan Choi, Youn Jin Lee, Keun Ho Hur, Sooyoung J Gynecol Oncol Original Article OBJECTIVE: To identify the incidence and clinical course of septic shock combined with neutropenia during chemotherapy in gynecological cancer patients. METHODS: We retrospectively reviewed the medical records of all gynecological cancer patients who received intravenous chemotherapy between March 2009 and March 2018. Patients diagnosed with neutropenic septic shock (NSS) during the course of chemotherapy were identified. We calculated the overall incidence and mortality rate of NSS, and analyzed risk factors and clinical course. RESULTS: A total of 1,009 patients received 10,239 cycles of chemotherapy during the study period. Among these, 30 (3.0%) patients had 32 NSS events, of which 12 (1.2%) died. With respect to patient age during the first course of chemotherapy, the incidence of NSS after the age of 50 was significantly higher than that in patients under 50 (3.9% vs. 1.4%, p=0.034). As the number of chemotherapy courses increased, the incidence of NSS increased, and linear-by-linear association analysis showed a positive correlation (p=0.004). NSS events occurred on average 7.8 days after the last cycle of chemotherapy, and the median duration of vasopressor administration was 23.3 hours. The median age (64.0 vs. 56.5, p=0.017) and peak heart rate (149.5 min(−1) vs. 123.5 min(−1), p=0.015) were significantly higher in the group of patients who subsequently died of NSS than in those who survived. CONCLUSION: The overall incidence of NSS in gynecological cancer patients receiving chemotherapy was 3.0%, which is higher than previously estimated. Peak heart rate during NSS events may be an indicator for predicting survival. Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2020-04-29 /pmc/articles/PMC7440980/ /pubmed/32808493 http://dx.doi.org/10.3802/jgo.2020.31.e62 Text en Copyright © 2020. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yoo, Jigeun
Jung, Yuyeon
Ahn, Jung Hwan
Choi, Youn Jin
Lee, Keun Ho
Hur, Sooyoung
Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
title Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
title_full Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
title_fullStr Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
title_full_unstemmed Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
title_short Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
title_sort incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440980/
https://www.ncbi.nlm.nih.gov/pubmed/32808493
http://dx.doi.org/10.3802/jgo.2020.31.e62
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