Sepsis and Septic Shock Definitions in Patients With Cancer Admitted in ICU.

Area of Science:

• Critical Care Medicine
• Oncology
• Infectious Diseases

Background:

• A new definition for sepsis and septic shock was established in 2016.
• Previous studies indicated the Sequential Organ Failure Assessment (SOFA) score's superiority over Systemic Inflammatory Response Syndrome (SIRS) criteria for predicting mortality in general ICU populations.

Purpose of the Study:

• To evaluate the accuracy of SOFA, quick SOFA (qSOFA), and SIRS criteria in predicting hospital mortality among cancer patients with suspected infections.
• To assess the applicability of the new sepsis and septic shock definition in an oncological intensive care unit (ICU) setting.

Main Methods:

• Analysis of patient records from an oncological ICU between January 1, 2013, and December 31, 2016.
• Calculation and comparison of SOFA, qSOFA, and SIRS scores for predicting hospital mortality.
• Multivariate analysis to identify prognostic factors for hospital mortality.

Main Results:

• The study included 241 solid tumor and 112 hematological malignancy patients, with an overall hospital mortality rate of 37%.
• SOFA score demonstrated the highest accuracy in predicting hospital mortality (AUC 0.74), followed by qSOFA (AUC 0.65) and SIRS (AUC 0.58).
• Higher SOFA and qSOFA scores were associated with poor prognosis (OR 1.28 and 1.48, respectively), while complete remission was a favorable prognostic factor (OR 0.39).

Conclusions:

• The 2016 sepsis and septic shock definition is reliably applicable to the oncological ICU population.
• The SOFA score is a more accurate predictor of hospital mortality than qSOFA and SIRS criteria in this patient cohort.