Endpoint-specific mortality associated with malignancy among adults with sepsis or septic shock: a systematic review and meta-analysis

Sepsis is a major global health challenge and increasingly affects patients with complex conditions such as malignancy. Prior studies suggest higher mortality in this population, but interpretation is limited by aggregation of heterogeneous endpoints. We conducted a systematic review and meta-analysis to clarify endpoint-specific prognostic associations between malignancy and mortality in adults with sepsis or septic shock.

This study was registered in PROSPERO (CRD420251141216). PubMed, Embase, Web of Science, Cochrane Library and Epistemonikos were searched through 16 September 2025, for studies comparing all-cause mortality between sepsis patients with and without malignancy. Mortality endpoints were grouped as ICU, in-hospital, early, intermediate and extended follow-up mortality. Crude odds ratios (ORs) were estimated using random-effects meta-analysis. Subgroup, meta-regression and sensitivity analyses were performed to explore heterogeneity and assess consistency.