Prevalence and Outcomes of Sepsis in Patients With Colon Carcinoma: Organism-Specific Analysis

Cureus. 2024 Nov 21;16(11):e74175. doi: 10.7759/cureus.74175. eCollection 2024 Nov.

Abstract

Background Sepsis is a challenging condition, especially in patients with malignancy, that is associated with worse mortality and increased complications. This study aimed to analyze the prevalence of sepsis, its complications, healthcare outcomes, and associated organism-specific mortality in patients with colorectal carcinoma using the National Inpatient Sample database. Methodology We included patients aged >18 years with a primary diagnosis of colon cancer. The patients were divided into two groups, those with sepsis and those without sepsis. Confounders were adjusted using multivariate regression analysis. We examined outcomes including mortality, hospital charges, length of stay, and other associated complications. Results Out of 876,769 patients diagnosed with colon cancer, 2,579 (0.2%) had methicillin-resistant Staphylococcus aureus (MRSA) sepsis, 1,004 (0.1%) had Staphylococcus aureus sepsis, and 6,439 (0.7%) had Escherichia coli sepsis. Patients with sepsis exhibited significantly longer hospital stays, the highest with Staphylococcus aureus and Enterococcus, as well as increased healthcare costs compared to those without sepsis. The highest mortality rates were associated with Staphylococcus aureus (n = 169/1,004, 17%), followed by Pseudomonas (n = 150/940, 16%) and MRSA (n = 374/2,579, 14%). Sepsis also led to higher rates of complications, including acute kidney injury and septic shock. Conclusions Through this study, we aim to highlight the need for early diagnosis and targeted management of colon cancer patients who develop sepsis during their hospital course. Future research should focus on the underlying pathophysiology and effective interventions to improve outcomes for patients with colorectal carcinoma and sepsis.

Keywords: cancer-specific outcome; outcomes of colon cancer; sepsis and shock physiology; sepsis-related organ failure assessment; staphylococcus aureus bacteremia.