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Critically ill patients with cancer and sepsis: Clinical course and prognostic factors

Autor(es): Rosolem, Maíra M; Rabello, Lígia S. C.F; Lisboa, Thiago; Caruso, Pedro; Costa, Ramon T; Leal, Juliana V. R; Salluh, Jorge I. F; Soares, Márcio
Fonte: Journal of Critical Care;1: [s.p.], 2011. ilus, mono
Artigo [ ID: 25280 ] Idioma(s): Inglês
AbstractPurpose: The purposes of this study were to evaluate the clinical course and to identify independentpredictors of mortality in patients with cancer with sepsis.Materials and Methods: This is a secondary analysis of a prospective cohort study conducted at anoncological medical-surgical intensive care unit. Logistic regression was used to identify predictors ofhospital mortality.Results: A total of 563 patients (77%solid tumor, 23% hematologic malignancies) were included over a 55-month period. The most frequent sites of infection were the lung, abdomen, and urinary tract; 91% patientshad severe sepsis/septic shock. Gram-negative bacteria were responsible for more than half of the episodes ofinfection; 38% of patients had polymicrobial infections. Intensive care unit, hospital, and 6-month mortalityrates were 51%, 65%, and 72%, respectively. In multivariate analyses, sepsis in the context of medicalcomplications; active disease; compromised performance status; presence of 3 to 4 systemic inflammatoryresponse syndrome criteria; and the presence of respiratory, renal, and cardiovascular failures wereassociated with increased mortality. Adjusting for other covariates, patients with non–urinary tractinfections, mostly represented by patients with pneumonia and abdominal infections, had worse outcomes.Conclusions: Sepsis remains a frequent complication in patients with cancer and associated with highmortality. Our results can be of help to assist intensivists in clinical decisions and to improve characterizationand risk stratification in these patients.(AU)
Localização: BR440.1