Cancer patients with septic shock: mortality predictors and neutropenia

To study outcome and its predictive factors in cancer patients admitted to the ICU with septic shock, and the implications of neutropenia as a risk factor in this advanced stage of systemic inflammatory response. A prospective consecutive observational cohort study was conducted in 73 adults with ca...

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Bibliographic Details
Published in:Supportive care in cancer 2004-12, Vol.12 (12), p.833-839
Main Authors: Regazzoni, Carlos J, Irrazabal, Célica, Luna, Carlos M, Poderoso, Juan J
Format: Article
Language:English
Subjects:
APACHE
Cancer
Chi-Square Distribution
Female
Humans
Hyperglycemia
Intensive Care Units
Logistic Models
Male
Medical research
Middle Aged
Mortality
Neoplasms - mortality
Neutropenia - mortality
Predictive Value of Tests
Prospective Studies
Risk Factors
Shock, Septic - microbiology
Shock, Septic - mortality
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Summary:To study outcome and its predictive factors in cancer patients admitted to the ICU with septic shock, and the implications of neutropenia as a risk factor in this advanced stage of systemic inflammatory response. A prospective consecutive observational cohort study was conducted in 73 adults with cancer and septic shock admitted to the ICU at the Cancer Medical Center associated with the University of Buenos Aires. The mortality rate from septic shock was 53.4% (95%CI 41.9 to 64.8%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission, the mean number of organ dysfunctions on admission or during the ICU stay, liver dysfunction, respiratory dysfunction, and the need for mechanical ventilation were predictive of mortality in a univariate analysis. Neutropenia was not associated with a worse prognosis in terms of mortality (56%) or mean days of ICU stay (6.64 days) in comparison with nonneutropenic patients (52.1% and 6.8 days) in the univariate analysis. In the logistic regression model only the need for mechanical ventilation and liver dysfunction remained independent predictors of mortality. Septic shock among cancer patients admitted to the ICU has a mortality rate similar to that reported for mixed populations, and it is particularly increased when hepatic or respiratory dysfunction develop. Neutropenia on admission does not seem to modify outcome.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-004-0667-5