Risco de infecção em adultos hospitalizados com câncer gastrointestinal em quimioterapia de infusão contínua: um estudo longitudinal

Abstract

Cancer is a multifactorial disease that culminates in genetic mutations, which alter cellular functions and activities. This condition can affect all organ systems in humans, including the gastrointestinal tract, which will be the focus of this study. A therapeutic approach commonly used in patients with gastrointestinal neoplasms is continuous infusion chemotherapy. This therapeutic choice often results in the need for hospital admission, increasing the risk of healthcare-associated infection. In this context, the nurse plays an essential role in the quality of care provided to oncology patients, since health promotion and prevention actions are crucial throughout the therapeutic pathway. The aim of the study is to compare the risk of infection in hospitalized adults with gastrointestinal cancer from the first (T0) to the sixth (T5) cycle of continuous-infusion chemotherapy. This is a prospective longitudinal study assessing possible changes in infection risk from the first (T0) to the sixth (T5) cycle of continuous infusion chemotherapy in adults with gastrointestinal cancer. The study will take place in the inpatient units of the oncology department of a referral hospital for cancer treatment in southern Brazil. The sampling method chosen is non-probabilistic by convenience, in which participants are all adults with a first diagnosis of gastrointestinal cancer who were hospitalized for continuous infusion chemotherapy at the data collection site during the study period, with participants included between January and October 2025, and follow-up extending until January 2026. Two instruments were used for data collection: one for sociodemographic and clinical characterization of the participants, and the RAC Adult Infection Risk Scale, which assesses the risk of infection in hospitalized adults. The collected data were tabulated, evaluated, and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 26.0. Regarding the results, there was a predominance of males (61%) among study participants, over 60 years of age, with a predominant diagnosis of colon neoplasms (36.60%), and more frequent use of the FOLFOX protocol (46.30%) as the selected therapy. There was a progressive reduction in the number of participants over the cycles, from 41 individuals in the first to 23 in the sixth. The statistical analysis showed a significant increase in infection risk between the first and second chemotherapy cycles (t(35) = 5.07; p < 0.001; means 16.28 to 17.67; d = 0.85) and between the first and sixth cycles (t(22) = 4.97; p < 0.001; means 16.39 to 18.09; d = 1.04), indicating a robust cumulative effect over the course of treatment. Based on the results, an increase in infection risk was observed among participants when comparing the first and sixth treatment cycles. This research reinforces the importance of equipping nurses with the skills for their care practice, especially regarding the nursing diagnosis of risk for infection.