Sepsis in patients with haematological versus solid cancer: a retrospective cohort study

OBJECTIVES: This study aims to examine the outcome of haematological and patients with solid cancer presenting with sepsis to the emergency department (ED). DESIGN: Single-centred, retrospective cohort study. Setting conducted at an academic emergency department of a tertiary hospital. PARTICIPANTS: All patients >18 years of age admitted with sepsis were included. INTERVENTIONS: Patients were stratified into two groups: haematological and solid malignancy. PRIMARY AND SECONDARY OUTCOME: The primary outcome of the study was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) mortality, ICU and hospital lengths of stay and mechanical ventilation duration. RESULTS: 442 sepsis cancer patients were included in the study, of which 305 patients (69%) had solid tumours and 137 patients (31%) had a haematological malignancy. The mean age at presentation was 67.92 (±13.32) and 55.37 (±20.85) (p<0.001) for solid and liquid tumours, respectively. Among patients with solid malignancies, lung cancer was the most common source (15.6%). As for the laboratory workup, septic solid cancer patients were found to have a higher white blood count (12 576.90 vs 9137.23; p=0.026). During their hospital stay, a total of 158 (51.8%) patients with a solid malignancy died compared with 57 (41.6%) patients with a haematological malignancy (p=0.047). There was no statistically significant association between cancer type and hospital mortality (OR 1.15 for liquid cancer p 0.58). There was also no statistically significant difference regarding intravenous fluid administration, vasopressor use, steroid use or intubation. CONCLUSION: Solid tumour patients with sepsis or septic shock are at the same risk of mortality as patients with haematological tumours. However, haematological malignancy patients admitted with sepsis or septic shock have higher rates of bacteraemia.