Mortality in sepsis among patients with gastrointestinal malignancies: a nationwide analysis 2017-2021
DOI:
https://doi.org/10.62838/jccm-2026-0056Keywords:
gastrointestinal, gastric, cancer, malignancies, sepsis, hepatocellularAbstract
Background: GLOBOCAN estimates that cancers such as gastric (mortality rate of 8.2%), pancreatic (4.5%), hepatic (8.2%), and colon (5.8%) are a significant public health burden for most countries. Literature is limited on determinants of mortality, hospital costs, and healthcare utilization among sepsis patients. This study aimed to identify the outcomes of sepsis in gastric, colon, hepatic, and pancreatic cancers in the United States.
Methods: We conducted a retrospective analysis using the National Inpatient Sample Database (2017-2021) using ICD-10 codes. Adults over the age of 18 years with malignancies were included. Confounding was reduced by propensity matching and multivariate regression. A p-value of ≤0.05 was considered significant.
Results: The prevalence of sepsis in gastric, colon, hepatic, and pancreatic cancers was 13.79%, 12.6%, 18.76%, and 19.22%, respectively. The mortality rates of each malignancy were higher in those with sepsis compared to those without sepsis (23.57% vs. 5.09%, 17.72% vs. 2.74%, 22.34% vs. 6.22%, and 17.26% vs. 5.11%, respectively). The mortality rate of each malignancy among patients requiring ICU level of care was 70.28%, 70.88%, 72.97%, and 67%, respectively. In all four malignancies, acute kidney injury, acute respiratory failure, invasive ventilation, disseminated intravascular coagulation, and shock were common factors associated with increased mortality (p<0.05). These patients incurred higher hospital charges and experienced longer hospital stays than compared to those without sepsis (p<0.001).
Conclusion: Our analysis revealed that patients with gastrointestinal malignancies experience high mortality rates when affected by sepsis, with acute organ dysfunction and the need for ICU-level care identified as key predictors of poor outcomes. This emphasizes the need for tailored management strategies to improve survival outcomes. Future studies should focus on treatment perspectives and guideline-directed therapies.
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Copyright (c) 2026 Barath Prashanth Sivasubramanian, Diviya Bharathi Ravikumar, Husna Qadeer, Abul Hasan Shadali Abdul Khader, Rhea Prasad, Sindhu Chandra Pokhriyal, Tenzin Tamdin, Deepak Venkataraman, Viraj Panchal, Vikramaditya Samala Venkata, Raghavendra Tirupathi, Rutul Dalal (Author)
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