Mortality in Cancer Patients with Septic Shock in Intensive Care: Systematic Review and Meta-Analysis

Area of Science:

• Oncology
• Critical Care Medicine
• Infectious Diseases

Background:

• Cancer patients often have compromised immune systems, increasing susceptibility to severe infections like sepsis.
• Despite progress in cancer therapies and sepsis treatment protocols, the incidence of critically ill cancer patients is rising.
• While survival for septic shock in cancer patients has improved, overall mortality rates remain alarmingly high.

Purpose of the Study:

• To systematically review and meta-analyze the mortality rate of septic shock in cancer patients.
• To identify variations in mortality rates based on time periods, geographic location, and care settings.

Main Methods:

• A comprehensive systematic search was conducted across major medical databases (Medline, EMBASE, SCOPUS, Web of Science, BIREME-BVS).
• Included studies focused on mortality in cancer patients over 18 years old experiencing septic shock.
• Methodological quality and risk of bias were assessed using the MInCir-Prognosis Scale and Joanna Briggs Institute checklist.

Main Results:

• The overall mortality rate for cancer patients with septic shock was 58% (95% CI: 54-63).
• Mortality rates showed regional variations, with North America reporting the highest at 64% (95% CI: 48-78).
• Mortality increased over time post-intensive care unit discharge, with 69% (95% CI: 58-80) at 180 days.

Conclusions:

• Septic shock continues to be a major cause of mortality in cancer patients, despite medical advancements.
• Mortality rates do not appear to be decreasing significantly over recent time periods.
• There is a critical need for improved management strategies, particularly for post-intensive care unit survival in this population.