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Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate.
López, René; Pérez-Araos, Rodrigo; Baus, Fernanda; Moscoso, Camila; Salazar, Álvaro; Graf, Jerónimo; Montes, José Miguel; Samtani, Suraj.
Afiliação
  • López R; Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile.
  • Pérez-Araos R; Escuela de Medicina, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
  • Baus F; Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile.
  • Moscoso C; Escuela de Kinesiología, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
  • Salazar Á; Escuela de Kinesiología, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
  • Graf J; Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile.
  • Montes JM; Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile.
  • Samtani S; Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile.
Front Med (Lausanne) ; 8: 603275, 2021.
Article em En | MEDLINE | ID: mdl-33981712
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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Front Med (Lausanne) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Chile País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Front Med (Lausanne) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Chile País de publicação: Suíça