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Related Concept Videos

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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
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  11. Long-term Survival Of Patients With Cancer, Sepsis, And Vasopressor Requirements Based On Lactate Levels.

Long-Term Survival of Patients With Cancer, Sepsis, and Vasopressor Requirements Based on Lactate Levels.

John A Cuenca1,2, Joseph L Nates1, Andres Laserna3

  • 1Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

Critical Care Explorations
|April 4, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Cancer patients with sepsis and vasopressor needs had similar 1-year survival whether they had high or normal lactate levels upon ICU admission. Overall survival remained low for this critically ill population.

Area of Science:

  • Critical Care Medicine
  • Oncology
  • Sepsis Research

Background:

  • Sepsis is a life-threatening condition with high mortality, especially in cancer patients.
  • Vasopressor use indicates severe sepsis and hemodynamic instability.
  • Lactate levels are a marker of tissue hypoperfusion and disease severity.

Purpose of the Study:

  • To evaluate the association between admission lactate levels and 1-year survival in critically ill cancer patients with sepsis and vasopressor requirements.
  • To determine if elevated lactate levels predict long-term outcomes in this specific patient cohort.

Main Methods:

  • Prospective cohort study design.
  • Inclusion of patients admitted to a Comprehensive Cancer Center's ICU with sepsis and vasopressor support.
  • Comparison of 1-year survival rates between patients with high lactate (> 2.0 mmol/L) and normal lactate (≤ 2.0 mmol/L) on admission.
Keywords:
cancerhematologicallactatemalignancies

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Main Results:

  • A total of 132 patients were included: 87 (66%) with high lactate and 45 (34%) with normal lactate.
  • 1-year survival rates were similar between the high lactate (16%) and normal lactate (18%) groups (p = 0.0921).
  • Adjusted analysis indicated no significant association between high lactate and 1-year survival (HR, 1.39; 95% CI, 0.94-2.05).
  • Overall 1-year survival for critically ill cancer patients with sepsis and vasopressor requirements was less than 20%.

Conclusions:

  • Admission lactate level was not a significant predictor of 1-year survival in cancer patients with sepsis and vasopressor requirements.
  • Critically ill cancer patients with sepsis and vasopressor needs have a poor long-term prognosis, irrespective of initial lactate levels.
  • Further validation in large multicenter cancer registries is recommended to confirm findings and understand long-term sepsis trajectories in this population.
sepsis
septic shock
solid tumors