Incidence and clinical outcomes of sweet syndrome in hospitalized cancer patients.

Abstract

e23085 Background: Sweet syndrome or febrile neutrophilic dermatosis has been noted to be associated with several underlying conditions such as malignancy, iatrogenic (drug-induced) or idiopathic in nature. It is often associated with fever, leukocytosis and erythematous skin changes and its diagnosis is confirmed by the presence of neutrophilic infiltrates in biopsy samples. The incidence and outcomes of Sweet syndrome in cancer patients over the past five years has not been described in medical literature. Methods: The National Inpatient Sample Database (2016-2021) and ICD-10 coding were utilized to identify adults (age ≥18 years) with Sweet syndrome and cancer. Various demographic and clinical characteristics of patients with Sweet syndrome and cancer were identified using ICD-10 codes. Multivariate logistic regression models were constructed to identify independent factors associated with mortality. Results: An estimated 11,745 patients were diagnosed with Sweet syndrome between 2016 to 2021 in the inpatient setting. The dominant age groups were 50-64 years and 65-79 years (33% each) with Caucasian race accounting for 76%. No gender predilection, as has been previously reported, was observed in our study. Mortality during hospitalization was not statistically significant in patients without cancer and those with cancer (amongst cancer patients: solid tumors – 4.6%, lymphoma – 3.6%, leukemia – 29.5%, myeloma – 2% or metastatic disease – 2.6%). Inpatient mortality did not change significantly over the studied 5-year period. using logistic regression, the variables identified as significantly associated with mortality included: age group of > 80 years (OR 6.1), African American race (OR 2.8), atrial fibrillation (OR 2.3), malnutrition (OR 1.9), anemia (OR 1.8) and multiple myeloma (5.35). Conclusions: Sweet syndrome in cancer patients is a poorly investigated disease entity and this study identifies important risk factors associated with inpatient mortality. While steroids remain the mainstay of treatment, it would be worthwhile to factor additional risk factors identified in this study towards designing a better treatment strategy to minimize their effect on mortality associated with this syndrome.