Mortality in patients with hematological malignancies, febrile neutropenia, and septic shock.
J Infect Dev Ctries
; 18(2): 235-242, 2024 Feb 29.
Article
in En
| MEDLINE
| ID: mdl-38484344
ABSTRACT
INTRODUCTION:
Patients with severe neutropenia who develop septic shock (SS) have high mortality. This study aimed to evaluate the risk factors and mortality of SS in patients with HM and febrile neutropenia.METHODOLOGY:
We included all patients with hematological malignancies (HM) who presented fever and severe neutropenia, admitted to an oncological tertiary care center in Mexico City for one year.RESULTS:
Two hundred ninety-two episodes of fever and severe neutropenia were documented; 68 patients (23.2%) developed SS. Documented clinical infection was different between SS and non-SS patients (94.1% vs. 63.4%, p < 0.001); pneumonia was the most frequent infection (36.8% vs. 23.2%, p = 0.02). Also, in SS vs. non-SS, there were more positive cultures (69.1% vs. 38.4%, p < 0.001), higher frequency of Gram-negative bacteria (89.3% vs. 63.9%, p < 0.001), particularly Escherichia coli (68% vs. 44.2%) and Klebsiella spp. (23.4% vs. 15.1%). There were no differences when multidrug-resistant (MDR) microorganisms were compared. In the multivariate analysis, associated risk factors for SS were prolonged neutropenia, a documented site of infection, and having received highly myelosuppressive chemotherapy. Risk factors for mortality at 30 days were older patients, prolonged neutropenia, and SS.CONCLUSIONS:
Severe and prolonged neutropenia was associated with SS development and mortality at 30 days. ICU management should be offered to all critically ill patients with HM if long-term survival of the underlying malignancy is expected.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock, Septic
/
Hematologic Neoplasms
/
Febrile Neutropenia
/
Neoplasms
Limits:
Humans
Language:
En
Journal:
J Infect Dev Ctries
/
J. infect. dev. ctries
/
Journal of infection in developing countries (Online)
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2024
Document type:
Article
Country of publication: