Infections in Solid Tumor Patients

2011 ◽  
pp. 39-45
Author(s):  
Alison G. Freifeld
Keyword(s):  
Solid Tumor ◽  
Tumor Patients

scholarly journals A TTP-incorporated scoring model for predicting mortality of solid tumor patients with bloodstream infection caused by Escherichia coli

2021 ◽  
Author(s):  
Qing Zhang ◽  
Hao-Yang Gao ◽  
Ding Li ◽  
Chang-Sen Bai ◽  
Zheng Li ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
High Risk ◽  
Bloodstream Infection ◽  
Solid Tumor ◽  
Prognostic Scores ◽  
Risk Scores ◽  
Youden Index ◽  
Tumor Patients ◽  
Scoring Model ◽  
Significant Difference

Abstract Background Few mortality-scoring models are available for solid tumor patients who are predisposed to develop Escherichia coli–caused bloodstream infection (ECBSI). We aimed to develop a mortality-scoring model by using information from blood culture time to positivity (TTP) and other clinical variables. Methods A cohort of solid tumor patients who were admitted to hospital with ECBSI and received empirical antimicrobial therapy was enrolled. Survivors and non-survivors were compared to identify the risk factors of in-hospital mortality. Univariable and multivariable regression analyses were adopted to identify the mortality-associated predictors. Risk scores were assigned by weighting the regression coefficients with corresponding natural logarithm of the odds ratio for each predictor. Results Solid tumor patients with ECBSI were distributed in the development and validation groups, respectively. Six mortality-associated predictors were identified and included in the scoring model: acute respiratory distress (ARDS), TTP ≤ 8 h, inappropriate antibiotic therapy, blood transfusion, fever ≥ 39 °C, and metastasis. Prognostic scores were categorized into three groups that predicted mortality: low risk (< 10% mortality, 0–1 points), medium risk (10–20% mortality, 2 points), and high risk (> 20% mortality, ≥ 3 points). The TTP-incorporated scoring model showed excellent discrimination and calibration for both groups, with AUC being 0.833 vs 0.844, respectively, and no significant difference in the Hosmer–Lemeshow test (6.709, P = 0.48) and the chi-square test (6.993, P = 0.46). Youden index showed the best cutoff value of ≥ 3 with 76.11% sensitivity and 79.29% specificity. TTP-incorporated scoring model had higher AUC than no TTP-incorporated model (0.837 vs 0.817, P < 0.01). Conclusions Our TTP-incorporated scoring model was associated with improving capability in predicting ECBSI-related mortality. It can be a practical tool for clinicians to identify and manage bacteremic solid tumor patients with high risk of mortality.

Clinical prediction of bacteremia and early antibiotics therapy in patients with solid tumors

2021 ◽  
pp. 1-7
Author(s):  
Jonathan M. Hyak ◽  
Mayar Al Mohajer ◽  
Daniel M. Musher ◽  
Benjamin L. Musher
Keyword(s):  
Solid Tumors ◽  
Solid Tumor ◽  
Cardiopulmonary Arrest ◽  
Tertiary Care ◽  
Organ Transplant ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Tumor Patients ◽  
Binomial Regression ◽  
Sirs Criteria

Abstract Objective: To investigate the relationship between the systemic inflammatory response syndrome (SIRS), early antibiotic use, and bacteremia in solid-tumor patients. Design, setting, and participants: We conducted a retrospective observational study of adults with solid tumors admitted to a tertiary-care hospital through the emergency department over a 2-year period. Patients with neutropenic fever, organ transplant, trauma, or cardiopulmonary arrest were excluded. Methods: Rates of SIRS, bacteremia, and early antibiotics (initiation within 8 hours of presentation) were compared using the χ2 and Student t tests. Binomial regression and receiver operator curves were analyzed to assess predictors of bacteremia and early antibiotics. Results: Early antibiotics were administered in 507 (37%) of 1,344 SIRS-positive cases and 492 (22%) of 2,236 SIRS-negative cases (P < .0001). Of SIRS-positive cases, 70% had blood cultures drawn within 48 hours and 19% were positive; among SIRS negative cases, 35% had cultures and 13% were positive (19% vs 13%; P = .003). Bacteremic cases were more often SIRS positive than nonbacteremic cases (60% vs 50%; P =.003), but they received early antibiotics at similar rates (50% vs 49%, P = .72). Three SIRS components predicted early antibiotics: temperature (OR, 1.7; 95% CI, 1.31–2.29; P = .0001), tachycardia (OR, 1.4; 95% CI, 1.10–1.69; P < .0001), and white blood-cell count (OR, 1.8; 95% CI, 1.56–2.14; P < .0001). Only temperature (OR, 1.6; 95% CI, 1.09–2.41; P = .01) and tachycardia (OR, 1.5; 95% CI, 1.09–2.06; P = .01) predicted bacteremia. SIRS criteria as a composite were poorly predictive of bacteremia (AUC, 0.57). Conclusions: SIRS criteria are frequently used to determine the need for early antibiotics, but they are poor predictors of bacteremia in solid-tumor patients. More reliable models are needed to guide judicious use of antibiotics in this population.

Tumor-associated antigen-based personalized dendritic cell vaccine in solid tumor patients

2020 ◽  
Vol 69 (7) ◽  
pp. 1375-1387
Author(s):  
Qian-Ting Wang ◽  
Ying Nie ◽  
Sheng-Nan Sun ◽  
Tao Lin ◽  
Ru-Jin Han ◽  
...  
Keyword(s):  
Dendritic Cell ◽  
Solid Tumor ◽  
Dendritic Cell Vaccine ◽  
Cell Vaccine ◽  
Tumor Patients ◽  
Tumor Associated Antigen

scholarly journals Phase 1 study of capmatinib in MET‐positive solid tumor patients: Dose escalation and expansion of selected cohorts

2019 ◽  
Vol 111 (2) ◽  
pp. 536-547 ◽  
Author(s):  
Yung‐Jue Bang ◽  
Wu‐Chou Su ◽  
Martin Schuler ◽  
Do‐Hyun Nam ◽  
Wan Teck Lim ◽  
...  
Keyword(s):  
Dose Escalation ◽  
Solid Tumor ◽  
Phase 1 ◽  
Tumor Patients ◽  
Phase 1 Study

scholarly journals Addressing the disparities and the factors related to prolonged inpatient length of stay for solid tumor oncology patients during the COVID-19 pandemic: A narrative review

2021 ◽  
Vol 5 (3) ◽  
pp. 046-053
Author(s):  
S Kamaraju ◽  
M Mohan ◽  
T Wright ◽  
J Charlson ◽  
W Wiger ◽  
...  
Keyword(s):  
Solid Tumor ◽  
Length Of Hospital Stay ◽  
Outpatient Setting ◽  
Acute Illness ◽  
Health Care Spending ◽  
Tumor Patients ◽  
Critical Areas ◽  
Life Issues ◽  
End Of Life Issues ◽  
Inpatient Length Of Stay

Solid tumor oncology treatments are primarily performed in the outpatient setting. However, hospitalizations are inevitable due to complications of cancer and treatment-related toxicities. With rising health care spending, the length of hospital stay (LOS) is increasingly considered a proxy for healthcare costs. There are several ongoing eff orts to abbreviate the inpatient LOS and ensure a safe and timely discharge to the outpatient setting. In addition to the acute illness and the associated comorbidities, various factors aff ect the LOS: social determinants of health (SDOH), nutritional status in cancer patients, and end-of-life issues. Furthermore, it is unclear how the institutional policies on social distancing and visitation during the current coronavirus disease (COVID-19) pandemic may impact the LOS. The purpose of this article is to review various factors and barriers that lead to longer LOS for solid tumor patients during the COVID-19 pandemic, and identify the critical areas of quality improvement.

scholarly journals Clinico-demographics and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study

2021 ◽  
Vol 25 (12) ◽  
pp. 1421-1426
Author(s):  
Atul P Kulkarni ◽  
Amit M Narkhede ◽  
Suhail S Siddiqui ◽  
Harish K Chaudhari ◽  
Jigeeshu V Divatia ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Solid Tumor ◽  
Outcome Predictors ◽  
Tumor Patients

Effectiveness of zolpidem and sleep hygiene counseling in the treatment of insomnia in solid tumor patients

2018 ◽  
Vol 25 (7) ◽  
pp. 1608-1612
Author(s):  
Amrita Asok ◽  
Sreelakshmi Sreekumar ◽  
Radhika TK ◽  
Anagha CC ◽  
Uma Devi P ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Solid Tumor ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Sleep Latency ◽  
Sleep Hygiene ◽  
Early Morning ◽  
Index Score ◽  
Tumor Patients ◽  
Falling Asleep

Objective To study the effectiveness of zolpidem and sleep hygiene counseling in managing insomnia in solid tumor patients. Methods Cancer patients with a Pittsburgh Sleep Quality Index score ≥ 5 were grouped into two. Both groups received treatment for insomnia in the form of either zolpidem 5 mg for 7 days or sleep hygiene counseling. Result At baseline, zolpidem and counseling group had a mean Pittsburgh Sleep Quality Index score of 14.82 ± 2.61 and 11.67 ± 3.32, respectively. The difference in mean Pittsburgh Sleep Quality Index score was found to be 4.03 in patients using zolpidem and 1.5 in counseled patients (p = 0.003). The components of Pittsburgh Sleep Quality Index namely difficulty falling asleep within 30 min (sleep latency), overall sleep quality, trouble staying awake during daytime and trouble staying motivated to get things done showed statistically significant improvement after treatment with zolpidem. Following sleep hygiene counseling, the proportion of patients with sleep latency > 30 min reduced considerably. Waking up to use the bathroom was the most common problem reported by approximately 94% patients in both groups before treatment which remained the most prevalent problem even after treatment. Night or early morning awakenings seemed to decrease significantly in patients taking zolpidem (p = 0.039) while it did not show any improvement with counseling. Counseling seemed to get patients to sleep within 30 min. Conclusion Patients on zolpidem showed a reduction in their Pittsburgh Sleep Quality Index scores thereby suggesting it as a treatment for insomnia in solid tumor patients. Sleep hygiene counseling, though not as effective as zolpidem, made a slight difference in the overall sleep.

Abstract 2229: Landscape of RB1 alterations in 22,432 Chinese solid tumor patients

2021 ◽  
Author(s):  
Nan Wang ◽  
Xueke She ◽  
Depei Huang ◽  
Xudong Shen ◽  
Hushan Zhang ◽  
...  
Keyword(s):  
Solid Tumor ◽  
Tumor Patients
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