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

• Published in: BMC infectious diseases 2019-10, Vol.19 (1), p.831-831, Article 831
• Main Authors: Dimopoulos, George, Rovina, Nikoletta, Patrani, Maria, Antoniadou, Eleni, Konstantonis, Dimitrios, Vryza, Konstantina, Vlachogianni, Glykeria, Kyprianou, Miltiades, Routsi, Christina, Giamarellos-Bourboulis, Evangelos J
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - complications; Aged; Aged, 80 and over; Cancer; Cardiovascular diseases; Chemotherapy; Comorbidity; Complications and side effects; Coronary artery disease; Coronary Disease - complications; Coronary heart disease; Demographic aspects; Female; Health hazards; Heart diseases; Humans; ICU; Independent variables; Infection; Infections; Infectious diseases; Injury analysis; Intensive care; Intensive Care Units; Male; Malignancy; Matching; Medical research; Middle Aged; Mortality; Neoplasm Staging; Neoplasms - complications; Neoplasms - pathology; Odds Ratio; Outcome; Patient admissions; Patient outcomes; Postoperative period; Procalcitonin; Propensity Score; Proportional Hazards Models; Regression analysis; Remission; Risk analysis; Risk Factors; Sepsis; Sepsis - mortality; Septic shock; Serum levels; Severity; Shock; Shock, Septic - complications; Solid tumors; Tumors; U-Plasminogen activator; Urokinase
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4448-7

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