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Severe sepsis is a costly complication in hospitalized cancer patients causing around one in ten cancer deaths each year in the United States, according to an article published today in Critical Care. The excessive response to infection in patients with severe sepsis injures critical organs such as the lungs and kidneys.
Dr. Mark Williams and his colleagues from Eli Lilly & Co. and Health Process Management, LLC used data from six U.S. states to analyze all the hospitalizations in 1999 and estimate the incidence of severe sepsis in cancer patients across the U.S., and the mortality rate of patients suffering from both conditions.
Almost 5 percent of the cancer patients that were hospitalized in the six states were found to have severe sepsis. When extrapolated to the rest of the U.S., this corresponds to around 126,000 cases every year.
The data also showed that hospitalized patients with cancer and severe sepsis were more than five times as likely to die than cancer patients not suffering from severe sepsis. 37.8 percent of patients with cancer and severe sepsis died in hospital in comparison to 7.2 percent of patients with cancer but no severe sepsis. This corresponds to the death of around 46,700 patients every year.
Our study demonstrates the devastating complication of severe infections in cancer patients. Improvement in infection control, such as early appropriate antibiotics, in this population could have a significant impact on overall cancer survival, said Williams.
Cancer treatments and the presence of tumors can cause patients with cancer to become immuno-suppressed. This hinders their ability to fight off infection, and makes them more at risk of severe sepsis than the general population.
In general, cancer patients were nearly four times as likely to be hospitalized with severe sepsis than people without cancer. Patients suffering from lymphoma, leukemia or other blood cancers were even more susceptible to severe sepsis than those suffering from cancer of a solid organ.
Patients with a blood cancer were 15 times more likely than the average person to suffer from severe sepsis. This higher rate corresponds to the fact that these patients are likely to be more severely immuno-compromised than patients with other forms of cancer.
We found that severe sepsis is a common, deadly, and costly complication in cancer patients, write the authors. This complication was associated with nearly a three-fold increase in the time spent in hospital. We estimate that the annual hospital costs for these patients exceed US$3 billion annually.
Williams MD, Braun LA, Cooper LM, Johnston J, Weiss RV, Qualy RL, and Linde-Zwirble W. Hospitalized cancer patients with severe sepsis: analysis of incidence, mortality, and associated costs of care. Critical Care 2004, 8:R291-R298.
Source: BioMed Central Limited