A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort

Justin Xavier Moore, Tomi Akinyemiju, Alfred Bartolucci, Henry E. Wang, John Waterbor, Russell Griffin

Research output: Contribution to journalArticle

Abstract

Background: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. Methods: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as “cancer survivors” or “no cancer history” derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer. We defined sepsis as hospitalization for a serious infection with ≥2 systemic inflammatory response syndrome criteria. We performed Cox proportional hazard models to examine the risk of sepsis after cancer (adjusted for sociodemographics, health behaviors, and comorbidities), and stratified by race. Results: Among 29,693 eligible participants, 2959 (9.97%) were cancer survivors, and 26,734 (90.03%) were no cancer history participants. Among 1393 sepsis events, the risk of sepsis was higher for cancer survivors (adjusted HR: 2.61, 95% CI: 2.29–2.98) when compared to no cancer history participants. Risk of sepsis after cancer survivorship was similar for Black and White participants (p value for race and cancer interaction = 0.63). Conclusion: In this prospective cohort of community-dwelling adults we observed that cancer survivors had more than a 2.5-fold increased risk of sepsis. Public health efforts should attempt to mitigate sepsis risk by awareness and appropriate treatment (e.g., antibiotic administration) to cancer survivors with suspected infection regardless of the number of years since cancer remission.

Original languageEnglish (US)
Pages (from-to)30-38
Number of pages9
JournalCancer Epidemiology
Volume55
DOIs
StatePublished - Aug 2018
Externally publishedYes

Fingerprint

Survivors
Sepsis
Stroke
Prospective Studies
Neoplasms
Independent Living
Systemic Inflammatory Response Syndrome
Health Behavior
Skin Neoplasms
Infection
Proportional Hazards Models
Comorbidity
Hospitalization
Survival Rate
Public Health

Keywords

  • Cancer survivors
  • Community-dwelling
  • Infection
  • Racial disparities
  • Sepsis
  • Survival analysis

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Cancer Research

Cite this

Moore, J. X., Akinyemiju, T., Bartolucci, A., Wang, H. E., Waterbor, J., & Griffin, R. (2018). A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort. Cancer Epidemiology, 55, 30-38. https://doi.org/10.1016/j.canep.2018.05.001

A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort. / Moore, Justin Xavier; Akinyemiju, Tomi; Bartolucci, Alfred; Wang, Henry E.; Waterbor, John; Griffin, Russell.

In: Cancer Epidemiology, Vol. 55, 08.2018, p. 30-38.

Research output: Contribution to journalArticle

Moore, JX, Akinyemiju, T, Bartolucci, A, Wang, HE, Waterbor, J & Griffin, R 2018, 'A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort', Cancer Epidemiology, vol. 55, pp. 30-38. https://doi.org/10.1016/j.canep.2018.05.001
Moore, Justin Xavier ; Akinyemiju, Tomi ; Bartolucci, Alfred ; Wang, Henry E. ; Waterbor, John ; Griffin, Russell. / A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort. In: Cancer Epidemiology. 2018 ; Vol. 55. pp. 30-38.
@article{7fcb21c3748741838c4e8272aee07601,
title = "A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort",
abstract = "Background: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. Methods: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as “cancer survivors” or “no cancer history” derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer. We defined sepsis as hospitalization for a serious infection with ≥2 systemic inflammatory response syndrome criteria. We performed Cox proportional hazard models to examine the risk of sepsis after cancer (adjusted for sociodemographics, health behaviors, and comorbidities), and stratified by race. Results: Among 29,693 eligible participants, 2959 (9.97{\%}) were cancer survivors, and 26,734 (90.03{\%}) were no cancer history participants. Among 1393 sepsis events, the risk of sepsis was higher for cancer survivors (adjusted HR: 2.61, 95{\%} CI: 2.29–2.98) when compared to no cancer history participants. Risk of sepsis after cancer survivorship was similar for Black and White participants (p value for race and cancer interaction = 0.63). Conclusion: In this prospective cohort of community-dwelling adults we observed that cancer survivors had more than a 2.5-fold increased risk of sepsis. Public health efforts should attempt to mitigate sepsis risk by awareness and appropriate treatment (e.g., antibiotic administration) to cancer survivors with suspected infection regardless of the number of years since cancer remission.",
keywords = "Cancer survivors, Community-dwelling, Infection, Racial disparities, Sepsis, Survival analysis",
author = "Moore, {Justin Xavier} and Tomi Akinyemiju and Alfred Bartolucci and Wang, {Henry E.} and John Waterbor and Russell Griffin",
year = "2018",
month = "8",
doi = "10.1016/j.canep.2018.05.001",
language = "English (US)",
volume = "55",
pages = "30--38",
journal = "Cancer Epidemiology",
issn = "1877-7821",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - A prospective study of cancer survivors and risk of sepsis within the REGARDS cohort

AU - Moore, Justin Xavier

AU - Akinyemiju, Tomi

AU - Bartolucci, Alfred

AU - Wang, Henry E.

AU - Waterbor, John

AU - Griffin, Russell

PY - 2018/8

Y1 - 2018/8

N2 - Background: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. Methods: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as “cancer survivors” or “no cancer history” derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer. We defined sepsis as hospitalization for a serious infection with ≥2 systemic inflammatory response syndrome criteria. We performed Cox proportional hazard models to examine the risk of sepsis after cancer (adjusted for sociodemographics, health behaviors, and comorbidities), and stratified by race. Results: Among 29,693 eligible participants, 2959 (9.97%) were cancer survivors, and 26,734 (90.03%) were no cancer history participants. Among 1393 sepsis events, the risk of sepsis was higher for cancer survivors (adjusted HR: 2.61, 95% CI: 2.29–2.98) when compared to no cancer history participants. Risk of sepsis after cancer survivorship was similar for Black and White participants (p value for race and cancer interaction = 0.63). Conclusion: In this prospective cohort of community-dwelling adults we observed that cancer survivors had more than a 2.5-fold increased risk of sepsis. Public health efforts should attempt to mitigate sepsis risk by awareness and appropriate treatment (e.g., antibiotic administration) to cancer survivors with suspected infection regardless of the number of years since cancer remission.

AB - Background: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. Methods: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as “cancer survivors” or “no cancer history” derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer. We defined sepsis as hospitalization for a serious infection with ≥2 systemic inflammatory response syndrome criteria. We performed Cox proportional hazard models to examine the risk of sepsis after cancer (adjusted for sociodemographics, health behaviors, and comorbidities), and stratified by race. Results: Among 29,693 eligible participants, 2959 (9.97%) were cancer survivors, and 26,734 (90.03%) were no cancer history participants. Among 1393 sepsis events, the risk of sepsis was higher for cancer survivors (adjusted HR: 2.61, 95% CI: 2.29–2.98) when compared to no cancer history participants. Risk of sepsis after cancer survivorship was similar for Black and White participants (p value for race and cancer interaction = 0.63). Conclusion: In this prospective cohort of community-dwelling adults we observed that cancer survivors had more than a 2.5-fold increased risk of sepsis. Public health efforts should attempt to mitigate sepsis risk by awareness and appropriate treatment (e.g., antibiotic administration) to cancer survivors with suspected infection regardless of the number of years since cancer remission.

KW - Cancer survivors

KW - Community-dwelling

KW - Infection

KW - Racial disparities

KW - Sepsis

KW - Survival analysis

UR - http://www.scopus.com/inward/record.url?scp=85047057889&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047057889&partnerID=8YFLogxK

U2 - 10.1016/j.canep.2018.05.001

DO - 10.1016/j.canep.2018.05.001

M3 - Article

C2 - 29763753

AN - SCOPUS:85047057889

VL - 55

SP - 30

EP - 38

JO - Cancer Epidemiology

JF - Cancer Epidemiology

SN - 1877-7821

ER -