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Abstract
Objectives To investigate whether patients under the care of the community specialist palliative care team receiving steroids are at increased risk of infection.
To identify other risk factors that predispose community palliative care patients to infection.
Methods A retrospective chart review of all patients referred to a community specialist palliative care service.
Results 177 adult patients were referred to the community specialist palliative care service. Corticosteroids were significantly associated with infection. 39% of patients who received an oral steroid had infection compared with 22% of those who did not receive steroids (OR 2.6 (95% CI 1.07 to 3), RR 1.78 (95% CI 1.08 to 2.9), p=0.02). Regular opioids were significantly associated with infection. 33% of patients receiving a regular opioid had an infection compared with 15% of those not receiving a regular opioid (OR 2.69 (95% CI 1.26 to 5.7), RR 2.06 (95% CI 1.2 to 3.8), p=0.008). Male gender, lung disease, diabetes and immunosuppressive therapies were associated with an increased rate of infection but were not statistically significant.
Conclusions Oral corticosteroids were associated with a significantly increased infection rate in a community palliative care population. These patients could potentially benefit from antibiotic prophylaxis while receiving corticosteroids.
- Cancer
- Chronic conditions
- Home Care Services
- Palliative Care
- Supportive care
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Footnotes
X @https://orcid.org/0000-0002-3571-2951
Contributors CK contributed to study conception and design, data acquisition, data analysis and report writing, drafting the report, revisions and approval for publication. CL contributed to data interpretation, revisions to the final report and approval for publication. IH contributed to data interpretation, revisions to the final report and approval for publication. CM was the guarantor/supervising author. She contributed to the study conception and design, data interpretation, revising the final report and approval for publication. CM accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controls the decision to publish.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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