ปัจปัจจัยที่สนับสนุนการติดเชื้อและความรุนแรงการติดเชื้อในผู้ป่วยมะเร็ง Influence Factors and Severity of Infections withจัยที่สนับสนุนการติดเชื้อและความรุนแรงการติดเชื้อในผู้ป่วยมะเร็ง Influence Factors and Severity of Infections within the Cancer Patient

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ทงเดชร ประเสริฐศรี นันธิดา พันธุศาสตร์

Abstract

This study was a survey study design which aimed to describe influencing factors and severity of infections within the cancer patient. A purposive sampling was used to recruit 126 samples .The sample included community acquired (CI) (n = 91, 72.2%) and healthcare associated infection nosocomial infection (NI) (n = 35, 27.8%). A structural recording form was used to collect the data which comprised of 3 parts including: 1) demographical information, 2) the infection form for cancer patients, and 3) the severity of infection form developed by the authors. Descriptive statistics were used to analyze the data including frequency, percentage, average and standard deviation.


The results from this study found in 126 participated .The sample included Community acquired (CI) (n = 91, 72.2%) and healthcare associated infection Nosocomial infection (NI) (n = 35, 27.8) found factors associated with influence factors and severity of infections within the cancer patient were 3 main factors as following:


Personal factors including age over 60 years (n = 57, 45.2%), ECOG score level 1 (n = 15, 11.9%) and Karnofsky status  found between 60% to 70%  (n =  27 ,  21.4%) and (n =  28 , 22.2%)  body mass index (BMI)  < 18.5 kg/m2 (n = 44, 34.9%), and hemoglobin <12 g/dl (n = 94, 74.6%).


Illness factors including being diagnosed as head and neck cancer (n = 57, 45.2%), had the fourth stage of cancer (n = 95, 75.4%), had moist desquamation (n = 66, 52.4%), and had cancer wound (n = 60, 47.6%), and had comorbid (n= 41, 32%) was hypertensions (n =34, 82.9%) and diabetes mellitus (n=14, 34.1%)


Treatment-related factor was a radiation therapy (n = 86, 68.3%), chemotherapy (n= 7, 5.6%) and treatment of both radiation therapy and chemotherapy (n=11, 8.7%)


                The period of having fever total (n = 94, 74.0%) and had fever over 3 days (n = 62, 65.9%), the average duration of fever was 9.86 days.  And the result white blood cell count (WBC) (n = 62, 65.9% ), white blood cell count >12,000 mm3 (n = 34 , 27.0%) , white blood cell count  <4,000 mm3  (n= 17,13.5%)  and absolute neutrophil count (ANC) < 2000 /mm3 (n= 11,8.7)  and was sepsis ( n = 61,64.9%) , septic shock (n= 1 ,1.1% ) , types of discharge (n = 95, 75.4%), and death (n = 14, 11.1%) were related to the severity of the infection.


These results could be used as baseline information to plan for the prevention of infections, reducing the severity of infections, reducing the length of stay in hospital, the cost of treatment, and reducing the death rate from infection in patients with cancer.

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ผู้ป่วยมะเร็ง ปัจจัยสนับสนุนการติดเชื้อ ความรุนแรงของการติดเชื้อ Cancer patients, influence factors, severity of infection