Long-Term Survival of Patients With Cancer, Sepsis, and Vasopressor Requirements Based on Lactate Levels

John A. Cuenca, MD; Joseph L. Nates, MD, MBA, MCCM; Andres Laserna, MD; Alba J. Heatter, MD; Nirmala Manjappachar, MD; Peyton Martin, BS; Maria P. Reyes, MD; Mike Hernandez, MS; Jacob Hall, PharmD; Claudia M. Ramirez, MD; Diego H. de Villalobos, MD

doi:10.1097/CCE.0000000000001070

Critical Care Explorations (Apr 2024)

Long-Term Survival of Patients With Cancer, Sepsis, and Vasopressor Requirements Based on Lactate Levels

John A. Cuenca, MD,
Joseph L. Nates, MD, MBA, MCCM,
Andres Laserna, MD,
Alba J. Heatter, MD,
Nirmala Manjappachar, MD,
Peyton Martin, BS,
Maria P. Reyes, MD,
Mike Hernandez, MS,
Jacob Hall, PharmD,
Claudia M. Ramirez, MD,
Diego H. de Villalobos, MD

Affiliations

John A. Cuenca, MD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Joseph L. Nates, MD, MBA, MCCM: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Andres Laserna, MD: 3 Department of Anesthesia and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY.
Alba J. Heatter, MD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Nirmala Manjappachar, MD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Peyton Martin, BS: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Maria P. Reyes, MD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Mike Hernandez, MS: 4 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
Jacob Hall, PharmD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Claudia M. Ramirez, MD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Diego H. de Villalobos, MD: 1 Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

DOI: https://doi.org/10.1097/CCE.0000000000001070
Journal volume & issue: Vol. 6, no. 4
p. e1070

Abstract

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A prospective cohort study was conducted to evaluate the 1-year survival of cancer patients with sepsis and vasopressor requirements. Eligible patients were admitted a Comprehensive Cancer Center’s ICU and were compared based on their admission lactate levels. Of the 132 included patients, 87 (66%) had high lactate (HL; > 2.0 mmol/L), and 45 (34%) had normal lactate (NL; ≤ 2.0 mmol/L). The 1-year survival rates of the two groups were similar (HL 16% vs. NL 18%; p = 0.0921). After adjustment for ICU baseline characteristics, HL was not significantly associated with a 1-year survival (Hazards ratio, 1.39; 95% CI, 0.94–2.05). Critically ill cancer patients with sepsis and vasopressor requirements, regardless of the lactate level, had 1-year survival of less than 20%. Large multicenter cancer registries would enable to confirm our findings and better understand the long-term trajectories of sepsis in this vulnerable population.

Published in Critical Care Explorations

ISSN: 2639-8028 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://journals.lww.com/ccejournal/pages/default.aspx

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