image: Sepsis incidence and mortality varied considerably by age. Sepsis incidence rates peaked in cancer patients aged 85 years and older, while the lowest rates were observed in cancer patients aged 25–29 years. Case fatality rate increased with age, and similar trends were observed for sepsis-related mortality. The lowest sepsis mortality rate occurred in patients aged 30–34 years.
Credit: ©Science China Press
This study is led by Prof. Bin Du, Li Weng (Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College), and Hongda Chen (Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College).
Sepsis is a severe condition caused by an excessive inflammatory response to infection, which can lead to tissue damage, organ failure, and death. Cancer patients, especially those undergoing treatments like chemotherapy and radiation, are at high risk due to immune suppression. They often experience prolonged hospital stays and frequent medical interventions, increasing their likelihood of infections that can progress to sepsis. In China, where cancer is a leading public health issue and accounts for approximately 30% of global cancer-related deaths, sepsis remains a major cause of mortality, second only to cancer progression itself. Despite improvements in cancer care, survival rates remain low for many advanced cancers. This study aimed to analyze trends in sepsis burden among hospitalized cancer patients in China from 2017 to 2019, examining the role of healthcare resource availability in sepsis outcomes.
This study was a nationwide observational study, drawing data from China’s National Data Center for Medical Service database, covering 3975 hospitals across the country. The study analyzed trends in sepsis burden among cancer patients from 2017 to 2019, focusing on in-hospital mortality and regional healthcare disparities.
Between 2017 and 2019, 1,126,191 hospitalized non-child cancer patients were included in the study, with 175,385 (15.6%) deaths during hospitalization. Patients who died were older and had higher Charlson Comorbidity Index scores, with respiratory, cardiovascular, and hematologic dysfunctions being the most common causes. Sepsis incidence increased by 35.3% over the three years, from 4111.20 to 5564.42 per 100,000 admissions. Although sepsis-related mortality rose by 53%, the case fatality rate slightly declined. Sepsis incidence and mortality rates were higher in older patients, with the highest rates observed in those aged 85 and above.
In conclusion, this nationwide study highlights the growing burden of sepsis among hospitalized cancer patients in China, with both sepsis incidence and mortality rising significantly from 2017 to 2019. To mitigate sepsis-related mortality in cancer patients, targeted interventions focusing on infection prevention, early detection, and timely management are essential, particularly in regions with limited healthcare resources.
Journal
Medicine Plus