Factores de riesgo asociados a sepsis en pacientes oncológicos admitidos en cuidados intensivos en Solca año 2018.

Abstract

Background: Sepsis and cancer are among the leading causes of death worldwide. However, epidemiological and prognostic data on these diseases are lacking in Ecuador. Studies that relate both diseases have been mostly carried out in developed countries. We performed a Case-Control study to determine risk factors associated with sepsis in an oncological critically ill population. Methods: This is a retrospective Case-Control study of patients admitted to the Intensive Care Unit (ICU) at SOLCA Hospital in 2018. Electronic medical records were reviewed to build a comprehensive database. We compared and analyzed Septic vs non-septic patients. Results: A sample of 164 patients was obtained, 34.14% with a diagnosis of sepsis and 65.85% non-septic. A positive correlation between hematologic cancer and sepsis was found (OR=6.22, p=0.001). On the other hand, solid tumors had a protective effect against sepsis (OR=0.16, p=0.001). Obesity also behaved as a protector against sepsis (OR=0.55, p=0.18) while low weight increased the risk (OR=2.40, p=0.10), however none of them were significant. Neutropenia was determined as a risk factor (OR=4.76, p=0.0009). The ICU, hospital, and 28-day rate was 32.14%, 42.07%, and 35.71% in the septic patients and 16.66%, 20.37%, and 18.51% in non-septic patients respectively. Conclusion: Hematologic cancer and neutropenia are risk factors for sepsis in oncological patients admitted to the ICU. No consensus was reached for the relationship between body mass index and the development of sepsis. Sepsis nearly doubled the mortality rates within this population. The lack of studies on these diseases in developing countries should be resolved, the incidence and mortalities could be far more alarming than those shown in reference studies.