Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers

다국어 초록 (Multilingual Abstract)

Objective: To identify the incidence and clinical course of septic shock combined withneutropenia during chemotherapy in gynecological cancer patients.
Methods: We retrospectively reviewed the medical records of all gynecological cancerpatients who received intravenous chemotherapy between March 2009 and March 2018.
Patients diagnosed with neutropenic septic shock (NSS) during the course of chemotherapywere identified. We calculated the overall incidence and mortality rate of NSS, and analyzedrisk factors and clinical course.
Results: A total of 1,009 patients received 10,239 cycles of chemotherapy during the studyperiod. Among these, 30 (3.0%) patients had 32 NSS events, of which 12 (1.2%) died. Withrespect to patient age during the first course of chemotherapy, the incidence of NSS after theage of 50 was significantly higher than that in patients under 50 (3.9% vs. 1.4%, p=0.034).
As the number of chemotherapy courses increased, the incidence of NSS increased, andlinear-by-linear association analysis showed a positive correlation (p=0.004). NSS eventsoccurred on average 7.8 days after the last cycle of chemotherapy, and the median durationof vasopressor administration was 23.3 hours. The median age (64.0 vs. 56.5, p=0.017) andpeak heart rate (149.5 min−1 vs. 123.5 min−1, p=0.015) were significantly higher in the group ofpatients who subsequently died of NSS than in those who survived.
Conclusion: The overall incidence of NSS in gynecological cancer patients receivingchemotherapy was 3.0%, which is higher than previously estimated. Peak heart rate duringNSS events may be an indicator for predicting survival.

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