Objective:
To characterize the presentation of sepsis among
active cancer patients compared with non-cancer patients and assess associated clinical
outcomes.
Aims:
1. To determine the prevalence of septic “active cancer patients” (undergoing
active cancer treatment) who present to the emergency department with or
without meeting SIRS criteria, and to compare their clinical outcomes to septic
non cancer patients presenting to the emergency department.
2. To compare the proportion of and clinical outcomes of septic patients presenting
to the emergency department with hypotension (SBP < 90 mmHg or MAP < 65
mmHg) and with < 2 SIRS criteria (i.e., not meeting sepsis definition) among
active cancer versus non-cancer groups.
3. To investigate mortality among septic active-cancer patients presenting
to the emergency department compared to septic non active cancer patients.
Study Endpoints:
1. Primary Outcome: To assess the proportion of and clinical outcomes of
septic active-cancer patients presenting to the emergency department with
hypotension (SBP < 90 mmHg or MAP < 65 mmHg) and with < 2 SIRS
criteria (i.e., not meeting sepsis definition).
Secondary Outcomes: Hospital and 28day mortality, Length
of stay.
Patients had a final diagnosis according to ICD-9 as sepsis,
bacteremia or septic shock. The population was divided into two groups:
Group A included active cancer patients and group B included non-cancer
patients. Each group was subsequently divided into 2 groups: SBP < 90
mmHg and ≥ 90 mmHg. We looked at the presence of SIRS criteria in these
groups. We speculated that the
hypotensive (SBP ≤90 mmHg) category in Group A exhibited less incidence of
“presence of 2 SIRS criteria” compared to the hypotensive (SBP ≤90 mmHg)
category in Group B.
This is a retrospective study. The study population consisted of
patients admitted to AUBMC through AUBMC-ED over the past 10 years. The AUBMC
admissions, ED and ICD-9 clinical databases were queried for the period
between January 1, 2004-December 31, 2013.
Inclusion Criteria:
Patients with active solid or hematologic malignancies (undergoing active treatment; chemotherapy, radiation therapy or surgery)
Final diagnosis according to ICD-9 as sepsis, bacteremia or septic shock
Age ≥ 18 years
Exclusion Criteria:
Age < 18 years
Cardiac arrest on presentation
Pregnant patients
Trauma Patients