Association between site of infection and mortality in patients with cancer with sepsis or septic shock: A retrospective cohort study

Chen, Youli; Huang, Jikun; Xu, Jia; Qiu, Rongzhe; Lin, Tianlai

doi:10.3892/etm.2022.11732

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…32 Although several studies have reported the close relationship between the infection origin and prognosis in sepsis patients, different patient inclusion criteria and comorbidities would have non-negligible impact on the observed endpoint event. [32][33][34][35][36] In this study, the infection site was not associated with mortality, which could be partly explained by the late disease status of involved patients (septic shock) in this study other than the early status in previous data (sepsis). 37,38 Many scoring tools to evaluate the prognosis of patients with sepsis or septic shock, such as SOFA, qSOFA, and SIRS standard, exist.…”

Section: Comparison To the Sofa Scoring Model And Machine Learning Modelcontrasting

confidence: 50%

An Individualized Nomogram for Predicting Mortality Risk of Septic Shock Patients During Hospitalization: A ten Years Retrospective Analysis

Wang,

Shi,

Pan

et al. 2023

IDR

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Purpose We intend to develop a nomogram for predicting the mortality risk of hospitalized septic shock patients. Patients and Methods Data were collected from patients hospitalized with septic shock in Affiliated Dongyang Hospital of Wenzhou Medical University in China, over 10 years between January 2013 and January 2023. The eligible study participants were divided into modeling and validation groups. Factors independently related to the mortality in the modeling group were obtained by stepwise regression analysis. A logistic regression model and a nomogram were built. The model was evaluated based on the discrimination power (the area under the curve of the receiver operating characteristic, AUC), the calibration degree and decision curve analysis. In the validation group, the discrimination powers of the logistic regression model, the sequential organ failure assessment (SOFA) scoring model and machine learning model were compared. Results A total of 1253 patients, including 878 patients in the modeling group and 375 patients in the validation group, were included in this study. Age, respiratory failure, serum cholinesterase, lactic acid, blood phosphorus, blood magnesium, total bilirubin, and pH were independent risk factors related to the mortality risk of septic shock. The AUCs of the prediction model for the modeling and validation groups were 0.881 and 0.868, respectively. The models had a good calibration degree and clinical applicability. The AUC of the SOFA model for the validation population was 0.799, significantly lower than that of our model. The AUCs of the random forest and ensemble models were 0.865 and 0.863, respectively, comparable to that of our logistical prediction model. Conclusion The model established in this study can effectively predict the mortality risk in patients hospitalized with septic shock. Thus, the model could be used clinically to determine the best therapy or management for patients with septic shock.

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Section: Comparison To the Sofa Scoring Model And Machine Learning Modelcontrasting

confidence: 50%

An Individualized Nomogram for Predicting Mortality Risk of Septic Shock Patients During Hospitalization: A ten Years Retrospective Analysis

Wang,

Shi,

Pan

et al. 2023

IDR

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The Role of PD-1/PD-L1 and IL-7 in Lymphocyte Dynamics and Sepsis Progression: A Biomarker Study in Critically Ill Patients

Coman,

Grigorescu,

Huțanu

et al. 2024

IJMS

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Sepsis pathophysiology involves a dysregulated immune response to infection, excessive inflammation, and immune paralysis. This study explores the relationships between cell death biomarkers (serum-soluble levels of programmed cell death protein 1 (PD-1), programmed death ligand 1 (PD-L1), and interleukin-7 (IL-7)) and the percentages of various lymphocyte subsets in relation to the severity and progression of sepsis. This prospective, observational study included 87 critically ill patients. We monitored parameters on days 1 (sepsis was diagnosed according to the Sepsis-3 Consensus) and 5. We established an IL-7 cutoff value of 1.94 pg/mL by comparing levels between a healthy control group and patients with sepsis (p < 0.0001). Lymphopenia was observed in all patients, with negative correlations between helper T lymphocytes and cytotoxic and B lymphocytes, and positive correlations involving cytotoxic lymphocytes across all groups. We found correlations between PD-1/PD-L1 and lymphocyte subsets. IL-7 showed a statistical correlation with PD-1 in non-survivors. Assessing lymphocyte levels shows potential as a biomarker for evaluating the progression of sepsis. Monitoring IL-7 levels could help assess survival, as low levels are associated with higher mortality risk. Monitoring IL-7 levels could help assess survival, as low levels are associated with higher mortality risk. Elevated PD-1/PD-L1 expression impairs costimulatory signalling, reducing T cell responses and lymphopenia, which increases the risk of nosocomial infections.

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The Role of Programmed Cell Death 1/Programmed Death Ligand 1 (PD-1/PD-L1) Axis in Sepsis-Induced Apoptosis

Coman,

Grigorescu,

Huțanu

et al. 2024

Medicina

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Background and Objectives: Sepsis involves a dysregulated host response, characterized by simultaneous immunosuppression and hyperinflammation. Initially, there is the release of pro-inflammatory factors and immune system dysfunction, followed by persistent immune paralysis leading to apoptosis. This study investigates sepsis-induced apoptosis and its pathways, by assessing changes in PD-1 and PD-L1 serum levels, CD4+ and CD8+ T cells, and Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) severity scores. Materials and Methods: This prospective, observational, single-centre study enrolled 87 sepsis patients admitted to the intensive care unit at the County Emergency Clinical Hospital in Târgu Mureș, Romania. We monitored the parameters on day 1 (the day sepsis or septic shock was diagnosed as per the Sepsis-3 Consensus) and day 5. Results: Our study found a statistically significant variation in the SOFA score for the entirety of the patients between the studied days (p = 0.001), as well as for the studied patient groups: sepsis, septic shock, survivors, and non-survivors (p = 0.001, p = 0.003, p = 0.01, p = 0.03). On day 1, we found statistically significant correlations between CD8+ cells and PD-1 (p = 0.02) and PD-L1 (p = 0.04), CD4+ and CD8+ cells (p < 0.0001), SOFA and APACHE II scores (p < 0.0001), and SOFA and APACHE II scores and PD-L1 (p = 0.001 and p = 0.01). On day 5, we found statistically significant correlations between CD4+ and CD8+ cells and PD-L1 (p = 0.03 and p = 0.0099), CD4+ and CD8+ cells (p < 0.0001), and SOFA and APACHE II scores (p < 0.0001). Conclusions: The reduction in Th CD4+ and Tc CD8+ lymphocyte subpopulations were evident from day 1, indicating that apoptosis is a crucial factor in the progression of sepsis and septic shock. The increased expression of the PD-1/PD-L1 axis impairs costimulatory signalling, leading to diminished T cell responses and lymphopenia, thereby increasing the susceptibility to nosocomial infections.

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Association between site of infection and mortality in patients with cancer with sepsis or septic shock: A retrospective cohort study

Cited by 3 publications

References 17 publications

An Individualized Nomogram for Predicting Mortality Risk of Septic Shock Patients During Hospitalization: A ten Years Retrospective Analysis

An Individualized Nomogram for Predicting Mortality Risk of Septic Shock Patients During Hospitalization: A ten Years Retrospective Analysis

The Role of PD-1/PD-L1 and IL-7 in Lymphocyte Dynamics and Sepsis Progression: A Biomarker Study in Critically Ill Patients

The Role of Programmed Cell Death 1/Programmed Death Ligand 1 (PD-1/PD-L1) Axis in Sepsis-Induced Apoptosis

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