{"doi":"10.6004/jnccn.2021.7046","title":"Outcomes and Predictors of 28-Day Mortality in Patients With Hematologic Malignancies and Septic Shock Defined by Sepsis-3 Criteria","abstract":"BACKGROUND: To describe short-term outcomes and independent predictors of 28-dayx mortality in adult patients with hematologic malignancies and septic shock defined by the new Third International Consensus Definitions (Sepsis-3) criteria. METHODS: We performed a retrospective cohort study of patients admitted to the medical ICU with septic shock from April 2016 to March 2019. Demographic and clinical features and short-term outcomes were collected. We used descriptive statistics to summarize patient characteristics, logistic regression to identify predictors of 28-day mortality, and Kaplan-Meier plots to assess survival. RESULTS: Among the 459 hematologic patients with septic shock admitted to the ICU, 109 (23.7%) had received hematopoietic stem cell transplant. The median age was 63 years (range, 18-89 years), and 179 (39%) were women. Nonsurvivors had a higher Charlson comorbidity index (P=.007), longer length of stay before ICU admission (P=.01), and greater illness severity at diagnosis and throughout the hospital course (P<.001). The mortality rate at 28 days was 67.8% and increased with increasing sequential organ failure assessment score on admission (odds ratio [OR], 1.11; 95% CI, 1.03-1.20), respiratory failure (OR, 3.12; 95% CI, 1.49-6.51), and maximum lactate level (OR, 1.16; 95% CI, 1.10-1.22). Aminoglycosides administration (OR, 0.42; 95% CI, 0.26-0.69), serum albumin (OR, 0.51; 95% CI, 0.31-0.86), and granulocyte colony-stimulating factor (G-CSF) (OR, 0.40; 95% CI, 0.24-0.65) were associated with lower 28-day mortality. Life support limitations were present in 81.6% of patients at death. At 90 days, 19.4% of the patients were alive. CONCLUSIONS: Despite efforts to enhance survival, septic shock in patients with hematologic malignancies is still associated with high mortality rates and poor 90-day survival. These results demonstrate the need for an urgent call to action with higher awareness, including the further evaluation of interventions such as earlier ICU admission, aminoglycosides administration, and G-CSF treatment.","journal":"Journal of the National Comprehensive Cancer Network","year":2022,"id":238430,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":54,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6509,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":738861,"name":"John Cuenca","orcid":"0000-0003-3228-2244","position":1,"is_corresponding":false},{"id":862742,"name":"Claudia Ramirez","orcid":null,"position":2,"is_corresponding":false},{"id":435754,"name":"Mike Hernández","orcid":"0000-0002-5074-5460","position":3,"is_corresponding":false},{"id":738863,"name":"Peyton Martin","orcid":"0000-0002-9501-3909","position":4,"is_corresponding":false},{"id":742205,"name":"María Pérez Reyes","orcid":"0000-0002-5942-1964","position":5,"is_corresponding":false},{"id":862743,"name":"Alba J. Heatter","orcid":null,"position":6,"is_corresponding":false},{"id":326200,"name":"Cristina Gutiérrez","orcid":"0000-0001-6381-6216","position":7,"is_corresponding":false},{"id":862216,"name":"Nisha Rathi","orcid":"0000-0003-4765-3415","position":8,"is_corresponding":false},{"id":15353,"name":"Charles L. Sprung","orcid":"0000-0002-2268-906X","position":9,"is_corresponding":false},{"id":738864,"name":"Kristen Price","orcid":"0000-0002-7102-8057","position":10,"is_corresponding":false},{"id":326210,"name":"Joseph L. Nates","orcid":"0000-0002-3190-3670","position":11,"is_corresponding":false},{"id":739403,"name":"Nirmala Manjappachar","orcid":null,"position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T00:22:26.932537Z","pmid":"34991066","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}