Infection-related hospitalizations in breast cancer patients: Risk and impact on prognosis

Judith S Brand, Edoardo Colzani, Anna L V Johansson, Johan Giesecke, Mark Clements, Jonas Bergh, Per Hall, Kamila Czene

Research output: Contribution to journalArticle (Academic Journal)

7 Citations (Scopus)

Abstract

OBJECTIVES: Infections are a common cause of hospitalization in breast cancer patients. We studied the risk, clinical characteristics and outcomes of infection-related hospitalizations in this patient population.

METHODS: A Swedish registry-based study including 8338 breast cancer patients diagnosed between 2001 and 2008, followed prospectively for infection-related hospitalizations until 2010. Standardized incidence ratios (SIRs) were calculated using background rates from the general female population. Associations with clinical characteristics and mortality were analyzed using flexible parametric survival models.

RESULTS: In total, 720 patients experienced an infection-related hospitalization during a median follow-up of 4.9 years. Infection rates were highest within the first year of diagnosis (SIR = 5.61, 95% CI; 4.98-6.32), and site-specific risks were most pronounced for sepsis (SIR = 3.14, 95% CI; 2.66-3.71) and skin infections (SIR = 2.80, 95% CI; 2.24-3.50). Older age at diagnosis, comorbidities, markers of tumor aggressiveness, chemotherapy and axillary node dissection were independent predictors of infectious disease risk. Infection-related hospitalizations were also independently associated with overall and breast cancer-specific death.

CONCLUSIONS: A significant number of breast cancer patients are hospitalized with an infection following diagnosis, which in turn predicts poor prognosis. The risk profile of infection-related hospitalizations is multifactorial, including patient, tumor and treatment-related factors.

Original languageEnglish
Pages (from-to)650-658
Number of pages9
JournalJournal of Infection
Volume72
Issue number6
DOIs
Publication statusPublished - Jun 2016

Keywords

  • Adult
  • Aged
  • Breast Neoplasms
  • Comorbidity
  • Female
  • Hospitalization
  • Humans
  • Incidence
  • Infection
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Registries
  • Risk Factors
  • Sweden
  • Journal Article

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  • Cite this

    Brand, J. S., Colzani, E., Johansson, A. L. V., Giesecke, J., Clements, M., Bergh, J., Hall, P., & Czene, K. (2016). Infection-related hospitalizations in breast cancer patients: Risk and impact on prognosis. Journal of Infection, 72(6), 650-658. https://doi.org/10.1016/j.jinf.2016.04.003