Clinical characteristics and prognostic factors of sepsis in patients with malignancy

Abstract Sepsis is a severe complication in patients with malignant tumors, leading to high mortality and increased need for intensive care. This study aimed to investigate the clinical characteristics and prognostic factors influencing sepsis outcomes in patients with malignant tumors. We included...

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Main Authors: Green Hong, Hyekyeong Ju, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-Man Lim, Song I Lee, The Korean Sepsis Alliance (KSA) investigators
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-87457-y
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author Green Hong
Hyekyeong Ju
Dong Kyu Oh
Su Yeon Lee
Mi Hyeon Park
Haein Lee
Chae-Man Lim
Song I Lee
The Korean Sepsis Alliance (KSA) investigators
author_facet Green Hong
Hyekyeong Ju
Dong Kyu Oh
Su Yeon Lee
Mi Hyeon Park
Haein Lee
Chae-Man Lim
Song I Lee
The Korean Sepsis Alliance (KSA) investigators
author_sort Green Hong
collection DOAJ
description Abstract Sepsis is a severe complication in patients with malignant tumors, leading to high mortality and increased need for intensive care. This study aimed to investigate the clinical characteristics and prognostic factors influencing sepsis outcomes in patients with malignant tumors. We included 4,858 patients with cancer diagnosed with sepsis between September 2019 and February 2020 whose data were collected from the Korean Sepsis Alliance, a nationwide multicenter cohort study. Cox regression analysis was used to identify predictors of 30-day and in-hospital mortality. In total, 65% of the patients survived, whereas 35% did not. Non-survivors were more likely to require intensive care, including mechanical ventilation and continuous renal replacement therapy. Key predictors of mortality included renal dysfunction, higher Sequential Organ Failure Assessment scores, and reliance on life-sustaining treatments. Non-survivors exhibited lower adherence to the implementation of sepsis care bundles, particularly to later-stage interventions. Gram-negative bacterial infections and multidrug resistance were more prevalent in non-survivors, complicating treatment efficacy. In conclusion, tailored treatment strategies that consider specific patient characteristics and disease dynamics are needed in managing sepsis with malignancy. Early identification and treatment of organ dysfunction, coupled with strict adherence to sepsis treatment protocols, are critical to improving survival in this population.
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spelling doaj-art-baea292f33fa4caea2159104c1792a562025-08-20T03:00:37ZengNature PortfolioScientific Reports2045-23222025-02-0115111110.1038/s41598-025-87457-yClinical characteristics and prognostic factors of sepsis in patients with malignancyGreen Hong0Hyekyeong Ju1Dong Kyu Oh2Su Yeon Lee3Mi Hyeon Park4Haein Lee5Chae-Man Lim6Song I Lee7The Korean Sepsis Alliance (KSA) investigatorsDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National School of Medicine, Chungnam National University HospitalDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National School of Medicine, Chungnam National University HospitalDepartment of Pulmonary and Critical Care Medicine, Dongkang Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDepartment of Pulmonary and Critical Care Medicine, Asan Medical CenterDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National School of Medicine, Chungnam National University HospitalAbstract Sepsis is a severe complication in patients with malignant tumors, leading to high mortality and increased need for intensive care. This study aimed to investigate the clinical characteristics and prognostic factors influencing sepsis outcomes in patients with malignant tumors. We included 4,858 patients with cancer diagnosed with sepsis between September 2019 and February 2020 whose data were collected from the Korean Sepsis Alliance, a nationwide multicenter cohort study. Cox regression analysis was used to identify predictors of 30-day and in-hospital mortality. In total, 65% of the patients survived, whereas 35% did not. Non-survivors were more likely to require intensive care, including mechanical ventilation and continuous renal replacement therapy. Key predictors of mortality included renal dysfunction, higher Sequential Organ Failure Assessment scores, and reliance on life-sustaining treatments. Non-survivors exhibited lower adherence to the implementation of sepsis care bundles, particularly to later-stage interventions. Gram-negative bacterial infections and multidrug resistance were more prevalent in non-survivors, complicating treatment efficacy. In conclusion, tailored treatment strategies that consider specific patient characteristics and disease dynamics are needed in managing sepsis with malignancy. Early identification and treatment of organ dysfunction, coupled with strict adherence to sepsis treatment protocols, are critical to improving survival in this population.https://doi.org/10.1038/s41598-025-87457-yCancerHematologic malignancyPrognosisSepsis
spellingShingle Green Hong
Hyekyeong Ju
Dong Kyu Oh
Su Yeon Lee
Mi Hyeon Park
Haein Lee
Chae-Man Lim
Song I Lee
The Korean Sepsis Alliance (KSA) investigators
Clinical characteristics and prognostic factors of sepsis in patients with malignancy
Scientific Reports
Cancer
Hematologic malignancy
Prognosis
Sepsis
title Clinical characteristics and prognostic factors of sepsis in patients with malignancy
title_full Clinical characteristics and prognostic factors of sepsis in patients with malignancy
title_fullStr Clinical characteristics and prognostic factors of sepsis in patients with malignancy
title_full_unstemmed Clinical characteristics and prognostic factors of sepsis in patients with malignancy
title_short Clinical characteristics and prognostic factors of sepsis in patients with malignancy
title_sort clinical characteristics and prognostic factors of sepsis in patients with malignancy
topic Cancer
Hematologic malignancy
Prognosis
Sepsis
url https://doi.org/10.1038/s41598-025-87457-y
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