Cancer Patients with Sepsis: Prognostic Insights from a Population-Based Cohort Study in Norway

Area of Science:

• Oncology
• Infectious Diseases
• Epidemiology

Background:

• Sepsis poses a higher mortality risk for cancer patients compared to non-cancer patients.
• The specific factors influencing this increased risk, such as cancer type, metastasis, patient demographics, and infecting microbe, require further investigation.

Purpose of the Study:

• To investigate the varying mortality risks associated with sepsis in cancer patients.
• To identify how cancer type, metastasis status, sex, age, and infecting microbe influence sepsis-related mortality in cancer patients.

Main Methods:

• A nationwide cohort study in Norway (2008-2021) analyzed adult patients hospitalized with sepsis.
• Data on cancer status, sepsis, and hospital mortality were extracted from the Norwegian Patient Registry (ICD-10 codes).
• Multivariable regression models were used to calculate absolute and relative risks of hospital mortality across different subgroups.

Main Results:

• The study included 222,832 sepsis patients, with 16.9% having cancer.
• Cancer patients exhibited higher hospital mortality rates: 16.2-16.9% for non-metastatic and 26.2-27.1% for metastatic disease.
• Adjusted relative risks (RR) for hospital death were significantly higher in cancer patients (1.39-2.75) compared to non-cancer patients, with metastatic disease showing the highest RR (up to 2.75).
• Mortality risk was particularly elevated in young adults (e.g., females 18-39 years: RR 8.28) and those with Gram-negative sepsis.

Conclusions:

• Increased hospital mortality in cancer patients with sepsis is significantly influenced by cancer type and the presence of metastasis.
• The highest mortality association was observed in females, young adults, and patients with Gram-negative sepsis.
• Understanding these specific risk factors can improve cancer patient care and inform the development of targeted sepsis therapies.