Sepsis epidemiology and prognosis in cancer patients: Preliminary results of a multicenter prospective observational study

Determination of risk factors for sepsis, focus of sepsis, causative microorganisms and mortality in cancer patients Patients and methods Prospective, observational planned. Patients diagnosed with cancer and hospitalized for any reason, followed for at least 72 h, were included. Demographic data, cancer diagnoses, presence of invasive equipment, chemotherapy and antimicrobial treatment histories of the patients were recorded. Sepsis scores, causative microorganisms, resistance profile and mortality were recorded. Results The mean age of 383 patients included in the study was 58 and 62% were male. 84% of the patients were followed up in internal clinics and the most common reason for follow-up was the chemotherapy plan. Non-Hodgkin lymphoma (29%) was the most prevalent kind of hematologic malignancy. During the patients' episode's follow-up, 36 cases of sepsis in 35 patients (9.1%) developed. Patients with sepsis had statistically significantly higher rates of hypertension(p = 0.01), coronary artery disease (p = 0.002), heart failure (p = 0.02), graft versus host disease (GVHD) (p = 0.012), hospitalization in the intensive care unit within the previous three months (p = 0.019), urethral catheter (p < 0.001), central catheter (p = 0.02), galactomannan positivity rate (p = 0.001), 28-day mortality (p < 0.001), and hospitalization in the intensive care unit (p = 0.019). GVHD in multivariate analysis (OR = 30.985 (4.459–215.304), p = 0.001), urethral catheter OR = 4.322 (1.533–12.184), p = 0.006) and CVC (OR = 2.870 (1.155–7.131), p = 0.023) were found to be risk factors for sepsis. Septic shock developed in 19 (52.8%) of the episodes and required ICU in 27 episodes. Treatment was initiated within the first hour in 31 episodes requiring crystalloids. In 33 episodes (91.7%), cultures were taken in the first hour and antibiotic treatment was started. The most common sepsis focus was lung. The causative agent was Gram-negative in 17 out of 23 bacteria isolated from the episodes. Multidrug resistance rate was 65%. The most commonly used antibiotics in empirical treatment were carbapenem (80.6%) and glycopeptides (44.4%). The mean duration of treatment was 10 days and the 28-day mortality rate was 66.7%. In multivariate analysis, it was concluded that the presence of sepsis increased mortality 9.6 times (OR = 9.682 (4.512–20.774), p < 0.001). Conclusion This is the first multicenter epidemiology study of sepsis in cancer patients in Turkey. The rate of development of sepsis was 9%, and the presence of GVHD and invasive device was the most important risk factor for sepsis. It was found that the development of sepsis increased the mortality 10 times. Rational use of catheters (if necessary, in accordance with asepsis, short-term) saves lives in cancer patients.