Pronostic à long terme du choc septique chez les patients ayant une pathologie oncologique ou hématologique (POH)

Abstract : Objectives: to determine the long-term prognosis of cancer patients (CP) admitted in intensive care unit for septic shock. Materials and Methods: it was a 5-year (2012-2016) monocenter prospective study in a 14-bed medical intensive care unit in a university hospital. All adult patients diagnosed for septic shock within the first 48 hours of ICU admission were included. Patients are included and classified in four groups: CP (solid cancer et hematological malignancy) and non-CP (immunocompromised or not). The primary outcome was the 180-day mortality. Results: 496 patients with septic shock were included: 244 (49%) NCP and 252 CP (119 (24%) with hematological malignancy and 133 (27%) with solid cancer). A withdrawal of treatments was decided for 52% of CP and 39% for NCP. CP mortality at 28-days and 180-days were 48 % and 60% respectively and were higher compared to NCP because of an excess of mortality in CP with solid cancer. After multivariate analysis, the 180-days mortality prognosis factors were poor performans status, high Charlson score index, high SAPS2 and SOFA score at admission and withdrawals of treatments. Conclusion: septic shock in malignancy patient was associated with a poor prognosis. Withdrawals treatments was the main prognosis factor and type or severity of malignancy was not associated with mortality.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02100154
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Submitted on : Monday, April 15, 2019 - 3:53:14 PM
Last modification on : Thursday, June 27, 2019 - 1:31:48 AM

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Marion Didier. Pronostic à long terme du choc septique chez les patients ayant une pathologie oncologique ou hématologique (POH). Médecine humaine et pathologie. 2019. ⟨dumas-02100154⟩

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