{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:31:45Z","timestamp":1792099905223,"version":"4.4.0"},"reference-count":74,"publisher":"Harborside Press, LLC","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> To describe short-term outcomes and independent predictors of 28-dayx mortality in adult patients with hematologic malignancies and septic shock defined by the new Third International Consensus Definitions (Sepsis-3) criteria. <jats:bold>Methods:<\/jats:bold> We performed a retrospective cohort study of patients admitted to the medical ICU with septic shock from April 2016 to March 2019. Demographic and clinical features and short-term outcomes were collected. We used descriptive statistics to summarize patient characteristics, logistic regression to identify predictors of 28-day mortality, and Kaplan-Meier plots to assess survival. <jats:bold>Results:<\/jats:bold> Among the 459 hematologic patients with septic shock admitted to the ICU, 109 (23.7%) had received hematopoietic stem cell transplant. The median age was 63 years (range, 18\u201389 years), and 179 (39%) were women. Nonsurvivors had a higher Charlson comorbidity index (<jats:italic>P<\/jats:italic>=.007), longer length of stay before ICU admission (<jats:italic>P<\/jats:italic>=.01), and greater illness severity at diagnosis and throughout the hospital course (<jats:italic>P<\/jats:italic>&lt;.001). The mortality rate at 28 days was 67.8% and increased with increasing sequential organ failure assessment score on admission (odds ratio [OR], 1.11; 95% CI, 1.03\u20131.20), respiratory failure (OR, 3.12; 95% CI, 1.49\u20136.51), and maximum lactate level (OR, 1.16; 95% CI, 1.10\u20131.22). Aminoglycosides administration (OR, 0.42; 95% CI, 0.26\u20130.69), serum albumin (OR, 0.51; 95% CI, 0.31\u20130.86), and granulocyte colony-stimulating factor (G-CSF) (OR, 0.40; 95% CI, 0.24\u20130.65) were associated with lower 28-day mortality. Life support limitations were present in 81.6% of patients at death. At 90 days, 19.4% of the patients were alive. <jats:bold>Conclusions:<\/jats:bold> Despite efforts to enhance survival, septic shock in patients with hematologic malignancies is still associated with high mortality rates and poor 90-day survival. These results demonstrate the need for an urgent call to action with higher awareness, including the further evaluation of interventions such as earlier ICU admission, aminoglycosides administration, and G-CSF treatment.<\/jats:p>","DOI":"10.6004\/jnccn.2021.7046","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T14:45:24Z","timestamp":1643381124000},"page":"45-53","source":"Crossref","is-referenced-by-count":54,"title":["Outcomes and Predictors of 28-Day Mortality in Patients With Hematologic Malignancies and Septic Shock Defined by Sepsis-3 Criteria"],"prefix":"10.6004","volume":"20","author":[{"given":"Nirmala K.","family":"Manjappachar","sequence":"first","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Cuenca","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia M.","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Hernandez","sequence":"additional","affiliation":[{"name":"2Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyton","family":"Martin","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria P.","family":"Reyes","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba J.","family":"Heatter","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Rathi","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles L.","family":"Sprung","sequence":"additional","affiliation":[{"name":"3Department of Anesthesiology, Critical Care Medicine and Pain Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen J.","family":"Price","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph L.","family":"Nates","sequence":"additional","affiliation":[{"name":"1Department of Critical Care, Division of Anesthesiology, Critical Care, and Pain, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"ref581","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1097\/CCM.0000000000001856","article-title":"ICU admission, discharge, and triage guidelines: a framework to enhance clinical operations, development of institutional policies, and further research","volume":"44","author":"Nates","year":"2016","journal-title":"Crit Care Med"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1097\/CCM.0000000000002512","article-title":"The impact of the Sepsis-3 septic shock definition on previously defined septic shock patients","volume":"45","author":"Sterling","year":"2017","journal-title":"Crit Care Med"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1001\/jama.2016.0289","article-title":"Developing a new definition and assessing new clinical criteria for septic shock: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Shankar-Hari","year":"2016","journal-title":"JAMA"},{"key":"ref641","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1097\/CCM.0000000000002156","article-title":"To SIRS with love\u2014an open letter","volume":"45","author":"Sprung","year":"2017","journal-title":"Crit Care Med"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"4063","DOI":"10.1002\/cncr.25306","article-title":"Predictors and outcome of acute kidney injury in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome","volume":"116","author":"Lahoti","year":"2010","journal-title":"Cancer"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"457","DOI":"10.6004\/jnccn.2017.0045","article-title":"Infusion-compatible antibiotic formulations for rapid administration to improve outcomes in cancer outpatients with severe sepsis and septic shock: the Sepsis STAT Pack","volume":"15","author":"Goldman","year":"2017","journal-title":"J Natl Compr Canc Netw"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1513\/AnnalsATS.201909-655OC","article-title":"Improvements in Sepsis-associated mortality in hospitalized patients with cancer versus those without cancer. 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