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Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate
The number of oncological patients (OP) admitted to intensive care units (ICU) for sepsis/septic shock has dramatically increased in recent years. The definition of septic shock has been modified, adding hyperlactatemia as a severity biomarker for mortality. However, it remains poorly reported in se...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107210/ https://www.ncbi.nlm.nih.gov/pubmed/33981712 http://dx.doi.org/10.3389/fmed.2021.603275 |
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author | López, René Pérez-Araos, Rodrigo Baus, Fernanda Moscoso, Camila Salazar, Álvaro Graf, Jerónimo Montes, José Miguel Samtani, Suraj |
author_facet | López, René Pérez-Araos, Rodrigo Baus, Fernanda Moscoso, Camila Salazar, Álvaro Graf, Jerónimo Montes, José Miguel Samtani, Suraj |
author_sort | López, René |
collection | PubMed |
description | The number of oncological patients (OP) admitted to intensive care units (ICU) for sepsis/septic shock has dramatically increased in recent years. The definition of septic shock has been modified, adding hyperlactatemia as a severity biomarker for mortality. However, it remains poorly reported in septic OP. We performed a retrospective analysis from a prospective database of sepsis/septic shock patients admitted to our ICU between September 2017 and September 2019 and followed until day 90. We identified 251 patients and 31.9% had active oncological comorbidity, mainly solid tumor (81.3%). Septic shock criteria were met for 112 (44.6%). Hyperlactatemia was observed in 136 (54.2%) patients and this was associated with a lower survival rate. Overall 90-day mortality was 15.1%. In OP vs. non-OP, hyperlactatemia was more frequent (65% vs. 49.1%, p = 0.013) and associated with lower survival (65.4% vs. 85.7%, p = 0.046). In OP, poor performance status was also associated with lower survival (HR 7.029 [1.998–24.731], p = 0.002) In an adjusted analysis, cancer was associated with lower 90-day survival (HR 2.690 [1.402–5.160], p = 0.003). In conclusion, septic OP remains a high mortality risk group in whom lactate levels and performance status could help with better risk stratification. |
format | Online Article Text |
id | pubmed-8107210 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81072102021-05-11 Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate López, René Pérez-Araos, Rodrigo Baus, Fernanda Moscoso, Camila Salazar, Álvaro Graf, Jerónimo Montes, José Miguel Samtani, Suraj Front Med (Lausanne) Medicine The number of oncological patients (OP) admitted to intensive care units (ICU) for sepsis/septic shock has dramatically increased in recent years. The definition of septic shock has been modified, adding hyperlactatemia as a severity biomarker for mortality. However, it remains poorly reported in septic OP. We performed a retrospective analysis from a prospective database of sepsis/septic shock patients admitted to our ICU between September 2017 and September 2019 and followed until day 90. We identified 251 patients and 31.9% had active oncological comorbidity, mainly solid tumor (81.3%). Septic shock criteria were met for 112 (44.6%). Hyperlactatemia was observed in 136 (54.2%) patients and this was associated with a lower survival rate. Overall 90-day mortality was 15.1%. In OP vs. non-OP, hyperlactatemia was more frequent (65% vs. 49.1%, p = 0.013) and associated with lower survival (65.4% vs. 85.7%, p = 0.046). In OP, poor performance status was also associated with lower survival (HR 7.029 [1.998–24.731], p = 0.002) In an adjusted analysis, cancer was associated with lower 90-day survival (HR 2.690 [1.402–5.160], p = 0.003). In conclusion, septic OP remains a high mortality risk group in whom lactate levels and performance status could help with better risk stratification. Frontiers Media S.A. 2021-04-26 /pmc/articles/PMC8107210/ /pubmed/33981712 http://dx.doi.org/10.3389/fmed.2021.603275 Text en Copyright © 2021 López, Pérez-Araos, Baus, Moscoso, Salazar, Graf, Montes and Samtani. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine López, René Pérez-Araos, Rodrigo Baus, Fernanda Moscoso, Camila Salazar, Álvaro Graf, Jerónimo Montes, José Miguel Samtani, Suraj Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate |
title | Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate |
title_full | Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate |
title_fullStr | Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate |
title_full_unstemmed | Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate |
title_short | Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate |
title_sort | outcomes of sepsis and septic shock in cancer patients: focus on lactate |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107210/ https://www.ncbi.nlm.nih.gov/pubmed/33981712 http://dx.doi.org/10.3389/fmed.2021.603275 |
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