Department of Oncology Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
School of Medicine, Xiamen University, Xiamen, China.
Front Cell Infect Microbiol. 2023 Aug 8;13:1228401. doi: 10.3389/fcimb.2023.1228401. eCollection 2023.
Bloodstream infections (BSIs) are one of the leading causes of death in cancer patients. Nevertheless, the risk factors of BSIs in solid tumors have rarely been ascertained adequately.
We conducted a single-center case-controlled retrospective study from 2017 to 2021 among adults with solid tumors in a tertiary-level hospital. The BSIs and control group were matched by the propensity score matching method. We found independent risk factors of occurrence and death of BSIs using univariate and multivariate regression analysis. Additionally, a nomogram was constructed to predict the risk of mortality in BSIs.
Of 602 patients with solid tumors in the study period, 186 had BSIs and 416 had non-BSIs. The incidence of BSIs was 2.0/1,000 admissions (206/102,704), and the 30-day mortality rate was 18.8% (35/186). Compared to the control group, the BSIs had longer hospital stays (24.5 days vs. 20.0 days), and higher frequency complicating with organ failure (10.5% vs. 2.4%), nephropathy (19.6% vs. 3.8%), comorbidities≥3 (35.5% vs. 20.0%), and liver-biliary-pancreatic infections (15.6% vs. 5.3%) (all P<0.001). Among the 186 patients with BSIs, 35 died within 30 days after BSIs. Gram-negative bacteria were the most frequent microorganisms (124/192, 64.6%). Liver cancer, organ failure, a high level of lactate dehydrogenase and septic shock were the independent hazardous factors for death of BSIs. What's more, a nomogram was constructed to predict the 30-day survival rate of BSIs, which was proved to have good accuracy (AUC: 0.854; 95% confidence interval: 0.785~0923) and consistency.
Being aware of the risk factors of BSIs redounds to take preventive measures to reduce the incidence and death of BSIs.
血流感染（BSI）是癌症患者死亡的主要原因之一。然而，实体瘤中 BSI 的危险因素很少得到充分确定。
我们进行了一项单中心病例对照回顾性研究，纳入了 2017 年至 2021 年在一家三级医院就诊的成年实体瘤患者。BSI 组和对照组采用倾向评分匹配法进行匹配。我们使用单变量和多变量回归分析发现 BSI 发生和死亡的独立危险因素。此外，还构建了一个列线图来预测 BSI 患者的死亡风险。
在研究期间的 602 名实体瘤患者中，186 名患有 BSI，416 名患有非 BSI。BSI 的发生率为 2.0/1000 人次（206/102704），30 天死亡率为 18.8%（35/186）。与对照组相比，BSI 组的住院时间更长（24.5 天 vs. 20.0 天），器官衰竭的发生率更高（10.5% vs. 2.4%），肾病（19.6% vs. 3.8%），合并症≥3 种（35.5% vs. 20.0%）和肝胆胰感染（15.6% vs. 5.3%）（均 P<0.001）。在 186 名 BSI 患者中，35 名患者在 BSI 后 30 天内死亡。革兰氏阴性菌是最常见的微生物（124/192，64.6%）。肝癌、器官衰竭、乳酸脱氢酶水平升高和感染性休克是 BSI 死亡的独立危险因素。此外，还构建了一个列线图来预测 BSI 的 30 天生存率，结果证明该列线图具有良好的准确性（AUC：0.854；95%置信区间：0.785~0923）和一致性。
了解 BSI 的危险因素有助于采取预防措施，降低 BSI 的发生率和死亡率。
