Predictors of short-term mortality in patients with sepsis and solid malignancies: a retrospective cohort study

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Abstract
INTRODUCTION: Patients with neoplasms are at increased risk of sepsis and adverse outcomes compared with the general population. Selecting an optimal treatment strategy for this patient population remains a challenging clinical task. OBJECTIVE: To identify independent predictors of 14- and 28-day mortality in cancer patients with sepsis. MATERIALS AND METHODS: A retrospective single-center cohort study was conducted including 97 patients with active solid malignancies and sepsis (Sepsis-3 criteria) admitted to the ICU between January 2019 and June 2025. Patients with hematological malignancies, disease remission, or palliative status were excluded. Demographic, clinical, oncological, and laboratory variables were analyzed. The primary outcomes were 14- and 28-day mortality. Independent predictors were identified using Firth-corrected multivariable logistic regression. RESULTS: 14-day mortality was 22.7 % (22/97) and 28-day mortality was 32.0 % (31/97). In multivariable analysis, the SOFA score was independently associated with 14-day mortality (OR 1.25; 95% CI 1.04–1.51; p = 0.015). Independent predictors of 28-day mortality were SOFA score (OR 1.26; 95% CI 1.06–1.52; p = 0.008) and ECOG performance status (OR 2.01; 95% CI 1.04–3.96; p = 0.037). CONCLUSIONS: A higher SOFA score was an independent predictor of both 14- and 28-day mortality, whereas poorer ECOG performance status independently predicted 28-day mortality.

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