title: Cancer Patients Are at High Risk of Mortality if Presenting with Sepsis at an Emergency Department.
abstract: BACKGROUND
  Sepsis is an emergency condition with high mortality and morbidity rate. There are limited data on the association of cancer as a risk factor for mortality in sepsis patients in the emergency department (ED).
  
  
  METHODS
  This retrospective study was conducted at the ED, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. The study period was between January 1st and December 31st, 2014. The inclusion criteria were as follows: adult patients over 15 years of age who presented at the ED with suspicion of sepsis, received treatment at the ED, and whose blood culture was found to be positive. Clinical data were recorded from medical records including the Mortality in Emergency Department Sepsis score (MEDS score). The primary outcome of this study was mortality at one month. Multivariate logistic regression analysis was used to identify independent factors associated with death.
  
  
  RESULTS
  During the study period, there were 775 eligible patients. The two most common pathogens identified from blood cultures were Staphylococcus aureus (193 patients; 24.9%) and Escherichia coli (158 patients; 20.4%). At one month after presenting at the ED, 110 patients (14.2%) had died. There were four significant factors for death, having cancer, being on an endotracheal tube, initial diagnosis of bacteremia, and high MED scores. Having cancer had an adjusted OR of 2.12 (95% CI of 1.29, 3.47).
  
  
  CONCLUSIONS
  Cancer patients have double the risk of mortality if presenting with sepsis at the ED.
authors: Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand Email : yuwares.sit@mahidol.ac.th.
authors: Thidathit
authors: T
authors: Prachanukool
authors: Panvilai
authors: P
authors: Tangkulpanich
authors: Possawee
authors: P
authors: Paosaree
authors: Kittisak
authors: K
authors: Sawanyawisuth
authors: Yuwares
authors: Y
authors: Sitthichanbuncha
mesh_terms: D000368:Aged; D004636:Emergency Service, Hospital; D004926:Escherichia coli / Q000472:pathogenicity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000382:microbiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000472:pathogenicity; D013785:Thailand