A Retrospective Study of Risk Factors for Infection in Cancer Patients Receiving Specialist Palliative Care

Yajima, Ryo; Ise, Yuya; Wako, Tetsuya; Katayama, Shirou; Kizu, Junko

doi:10.1272/jnms.80.481

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…At present, the insertion of gastrostomy and tracheostomy tube is a common practice in cases of hypoxic encephalopathy, especially in those whom rapid clinical improvement is not expected (22,23). By providing viruses and bacteria a direct entry to the lower respiratory tract, tracheostomy cannulas are known to predispose patients to respiratory tract infections and additionally lead to a local inflammatory reaction, further increasing the risk for infection (24,25). Furthermore, patients with chronic tracheostomy are exposed to bacterial colonization of the respiratory tract, a risk factor for respiratory tract infections (25).…”

Section: Discussionmentioning

confidence: 99%

Evalution of Geriatric Infections in Palliative Care Center

Akdoğan¹,

Kahveci²

2018

tjgeri

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Palliative care aims to improve quality of care by providing symptom control among geriatric patients; therefore, infection control is of utmost importance as complications increase symptom burden, thus decreasing quality of life. Materials and Method: Medical records of patients aged ≥65 years hospitalized at the palliative care center were retrospectively reviewed. Data on age, sex, diagnosis, comorbidities, length of stay, discharge status and cultures were collected. Results: Mean age of 305 patients was 80.4±7.1 years and length of stay was 31.1±38.1 days. In total, 131 patients died, whereas 74 were referred to the intensive care unit, and 100 were discharged home. Main comorbidities included cerebrovascular diseases (37.4%), cancer (31.8%), hypertension (40%) and diabetes mellitus (21.3%) in patients who had dementia and Parkinson's disease. The highest growth was observed in urinary culture (67.9%), followed by blood, wound with the least growth in the tracheal aspirate (8.2%). E.coli was most commonly isolated in urinary, wound and tracheal aspirate culture, whereas Methicillin-Resistant Coagulase Negative Staphylococ was more in blood culture. While wound culture growth was less common in cancer patients, it was significantly more common in patients with Parkinson's disease, diabetes, and pressure ulcer (p<0.05). Growth in the tracheal aspirate was also significantly more common in patients with hypoxic brain, percutaneous endoscopic gastrostomy, and tracheostomy (p<0.05). Conclusion: Among patients receiving inpatient palliative care, bacterial growth was most common in urinary cultures, whereas it was higher in the tracheal aspirates of patients with diabetes, tracheostomy, and percutaneous endoscopic gastrostomy.

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Section: Discussionmentioning

confidence: 99%

Evalution of Geriatric Infections in Palliative Care Center

Akdoğan¹,

Kahveci²

2018

tjgeri

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“…alyatif bakım alan hastaların, sahip oldukları kronik hastalıklar ve bu hastalıkların komplikasyonları, kanser gibi immün sistemin zayıfladığı durumlar, terminal dönem ve bedenin güçsüzlüğü gibi nedenlerden dolayı enfeksiyonlardan korunması oldukça önemlidir. Hastaların önlebilir enfeksiyonlardan korunması, yaşam kalitelerinin yükseltilmesi, mortalite hızlarının azaltılması ve semptom kontrolünde başarılı olunabilmesini sağlar (1,2). Palyatif bakım alan hastalarda genel olarak enfeksiyona neden olan faktörler öngörülebilir olsa da, bu konuda literatürde yeterince kaynak olmadığı görülmektedir (1).…”

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“…Hastaların önlebilir enfeksiyonlardan korunması, yaşam kalitelerinin yükseltilmesi, mortalite hızlarının azaltılması ve semptom kontrolünde başarılı olunabilmesini sağlar (1,2). Palyatif bakım alan hastalarda genel olarak enfeksiyona neden olan faktörler öngörülebilir olsa da, bu konuda literatürde yeterince kaynak olmadığı görülmektedir (1).…”

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“…Bunun dışında palyatif bakım alan hastalarda, yetersiz beslenme, immobilite, deri bütünlüğünün bozulması, dehidratasyon, invazif girişimler, kateter uygulamaları ve uzun süre hastanede yatma gibi nedenlerden dolayı da sıklıkla enfeksiyon gelişebilmektedir. İmmün sistemin zayıfladığı ya da baskılandığı durumlarda, vücudun savunma sistemi çöker, hücresel ve hümoral bağışıklık sistemi yetersiz kalır ve fırsatçı enfeksiyonlar ortaya çıkar (1,3,9). Hastaların enfeksiyon tedavisine/yönetimine uygun yanıtı vermemesi ya da antibiyotik dirençli enfeksiyon ajanların varlığı nedeniyle, sepsis gibi hastaların mortalite riskini artıran durumlarla da palyatif bakım alanlarında sıklıkla karşılaşılabilmektedir (9,10 (2,(11)(12)(13)(14).…”

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Palyatif Bakım Alan Kanser Hastalarında Enfeksiyon ve Yönetimi

Kapucu¹

2018

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Palyatif bakım alan kanser hastaları, immün sistemlerinin zayıflığına, hastane enfeksiyonlarına ve diğer nedenlere bağlı olarak enfeksiyona yatkındır. Bu nedenle hastalarda enfeksiyona bağlı mortalite hızı yüksektir. Enfeksiyonlardan hastaların korunmasında ve tedavisinde hemşirelere ve hekimlere çok önemli roller düşmektedir. Palyatif bakım alan kanser hastalarında görülen enfeksiyonlarla ilgili literatürün kısıtlı olduğu da dikkatimizi çekmiştir. Bu derleme makalenin yazılma amacı, alanda çalışan sağlık personelinin farkındalığını arttırmak ve literatütüre katkı sağlamaktır.

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Infections in hospitalised patients affected by end-stage diseases: a narrative overview

Sganga¹,

Salerno

Borghetti³

et al. 2022

Int J Palliat Nurs

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Aim: To analyse the presence and treatment of infections in hospitalised terminal patients by identifying potential risk factors. Methods: We conducted a retrospective study using health data from 229 terminally ill patients (evaluated by our hospital palliative care team (HPCT) hospitalised from January to December 2018. Results: A total of two types of infections were identified: blood flow infection (through blood cultures) and pneumonia (through radiological examinations), while the other cases of infection remained unknown. The most frequently identified microorganism was Staphylococcus spp. The prevalence of infections was higher in patients with non-oncological diseases (n=47, 36.7%; p value 0.009). The potential risk factors identified for infections were the presence of: Parkinson's disease (n=15, 11.7%; p value 0.005), dysphagia (n=49, 38.3%; p value 0.007), bedding (n=15, 11.7%; p value 0.048), pressure ulcers (n=31, 24. 2%); p value 0.018), oxygen therapy (n=60, 46.9%; p value 0.050), urinary catheters (n=95, 74.2%; p value 0.038) and polypathology (2.3 vs 1.7; p value 0.022). Parkinson's disease (OR=5.973; 95% CI=1.292-27.608), dysphagia (OR=2.090; 95% CI=1.080-4.046) and polypathology (OR=1.220; 95% CI=1.015-1.466) were confirmed by a corrected logistic regression analysis. Conclusions: Infections and, consequently, antibiotic therapies, have a high prevalence in hospitalised patients with terminal disease. Potential risk factors for infections in these patients could be polypathology, dysphagia and Parkinson's disease. Patients with these conditions could benefit from prevention programmes.

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A Retrospective Study of Risk Factors for Infection in Cancer Patients Receiving Specialist Palliative Care

Cited by 4 publications

References 11 publications

Evalution of Geriatric Infections in Palliative Care Center

Evalution of Geriatric Infections in Palliative Care Center

Palyatif Bakım Alan Kanser Hastalarında Enfeksiyon ve Yönetimi

Infections in hospitalised patients affected by end-stage diseases: a narrative overview

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