Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate
Date
2021
Type:
Article
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Abstract
The number of oncological patients (OP) admitted to intensive care units (ICU) for
sepsis/septic shock has dramatically increased in recent years. The definition of septic
shock has been modified, adding hyperlactatemia as a severity biomarker for mortality.
However, it remains poorly reported in septic OP. We performed a retrospective analysis
from a prospective database of sepsis/septic shock patients admitted to our ICU
between September 2017 and September 2019 and followed until day 90. We identified
251 patients and 31.9% had active oncological comorbidity, mainly solid tumor (81.3%).
Septic shock criteria were met for 112 (44.6%). Hyperlactatemia was observed in 136
(54.2%) patients and this was associated with a lower survival rate. Overall 90-day
mortality was 15.1%. In OP vs. non-OP, hyperlactatemia was more frequent (65% vs.
49.1%, p = 0.013) and associated with lower survival (65.4% vs. 85.7%, p = 0.046).
In OP, poor performance status was also associated with lower survival (HR 7.029
[1.998–24.731], p = 0.002) In an adjusted analysis, cancer was associated with lower
90-day survival (HR 2.690 [1.402–5.160], p = 0.003). In conclusion, septic OP remains a
high mortality risk group in whom lactate levels and performance status could help with
better risk stratification.
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Citation
López R, Pérez-Araos R, Baus F, Moscoso C, Salazar Á, Graf J, Montes JM, Samtani S. Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate. Front Med (Lausanne). 2021 Apr 26;8:603275. doi: 10.3389/fmed.2021.603275. PMID: 33981712; PMCID: PMC8107210.
Keywords
cancer, intensive care uni, septic shock, oncological patient, cancer prevention, control