[Evaluation of the importance of infection as cause of death in patients with malignancy: an analysis of autopsy cases].
The autopsy records of patients who died at Keio University Hospital from January 1, 1970 through December 31, 1974 and from January 1, 1985 through December 31, 1989, were reviewed and their main diseases and the causes of death were determined. The contribution of infections to the death of each patient was classified as follows: Class 1: Infection is the only cause of death. Class 2: Infection is the predominant cause of death. Class 3: Non-infectious disease is the predominant cause of death. Class 4: Infection is independent of patient's death. The total number of autopsy cases and cases with malignancy were 1,140 and 664 in the early 1970's and 1,136 and 826 in the late 1980's, respectively. Patients with hematologic malignancies totalled 90 and 95 in the two periods, respectively. In the early 1970's, 35% of patients with malignancies died of infections [classified as Class 1 (25%) and Class 2 (10%)], and in the late 1980's, 32% of cancer patients died of infections (Class 1 20% and Class 2 12%, respectively). The most important infectious disease was pulmonary infection in the two periods. In patients with other than hematologic cancers (solid cancers), 63% and 58% of patients died of pulmonary infection in the early 1970's and the late 1980's, respectively. The rate of solid cancer patients who died of systemic infection rose from 7% in the early 1970's to 21% in the late 1980's. In hematologic cancer patients, the importance of pulmonary infection and that of systemic infection were comparable in the two periods. Fungus infection in hematologic cancer patients was a serious problem in the two periods, but it became more important in the late 1980's. The most important cause of death of cancer patients in the two periods was the cancers themselves; 39% of patients in the early 1970's and 43% in the late 1980's, respectively, died of marasmus or insufficiency of vital organs due to cancer.
Kuramochi
S
S
Dept. of Pathology, Keio University School of Medicine, Tokyo, Japan.
Kameyama
K
K
Hiraoka
N
N
Hosoda
Y
Y
Kumai
K
K
Ishibiki
K
K
D002423:Cause of Death; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology; D009894:Opportunistic Infections / Q000150:complications / Q000401:mortality* / Q000473:pathology