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Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock.J Crit Care. 2010 Jun; 25(2):276-81.JC
Abstract
PURPOSE
The purpose of the study was to determine the independent risk factors on mortality in patients with community-acquired severe sepsis and septic shock.
METHODS
A single-site prospective cohort study was carried out in a medical-surgical intensive care unit in an academic tertiary care center. One hundred twelve patients with community-acquired bloodstream infection with severe sepsis and septic shock were identified. Clinical, microbiologic, and laboratory parameters were compared between hospital survivors and hospital deaths.
RESULTS
One-hundred twelve patients were included. The global mortality rate was 41.9%, 44.5% in septic shock and 34.4% in severe sepsis. One or more comorbidities were present in 66% of patients. The most commonly identified bloodstream pathogens were Escherichia coli (25%) and Staphylococcus aureus (21.4%). The proportion of patients receiving inadequate antimicrobial treatment was 8.9%. By univariate analysis, age, Acute Physiology and Chronic Health Evaluation II score, at least 3 organ dysfunctions, and albumin, but neither microbiologic characteristics nor site of infection, differed significantly between survivors and nonsurvivors. Acute Physiology and Chronic Health Evaluation II (odds ratio, 1.13; 95% confidence interval, 1.06-1.21) and albumin (odds ratio, 0.34; 95% confidence interval, 0.15-0.76) were independent risk factors associated with global mortality in logistic regression analysis.
CONCLUSION
In addition to the severity of illness, hypoalbuminemia was identified as the most important prognostic factor in community-acquired bloodstream infection with severe sepsis and septic shock.
Links
MeSH
Pub Type(s)
Journal Article
Language
eng
PubMed ID
20149587
Citation
Artero, Arturo, et al. "Prognostic Factors of Mortality in Patients With Community-acquired Bloodstream Infection With Severe Sepsis and Septic Shock." Journal of Critical Care, vol. 25, no. 2, 2010, pp. 276-81.
Artero A, Zaragoza R, Camarena JJ, et al. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock. J Crit Care. 2010;25(2):276-81.
Artero, A., Zaragoza, R., Camarena, J. J., Sancho, S., González, R., & Nogueira, J. M. (2010). Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock. Journal of Critical Care, 25(2), 276-81. https://doi.org/10.1016/j.jcrc.2009.12.004
Artero A, et al. Prognostic Factors of Mortality in Patients With Community-acquired Bloodstream Infection With Severe Sepsis and Septic Shock. J Crit Care. 2010;25(2):276-81. PubMed PMID: 20149587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock.
AU - Artero,Arturo,
AU - Zaragoza,Rafael,
AU - Camarena,Juan J,
AU - Sancho,Susana,
AU - González,Rosa,
AU - Nogueira,José M,
Y1 - 2010/02/10/
PY - 2009/08/17/received
PY - 2009/11/24/revised
PY - 2009/12/22/accepted
PY - 2010/2/13/entrez
PY - 2010/2/13/pubmed
PY - 2010/7/28/medline
SP - 276
EP - 81
JF - Journal of critical care
JO - J Crit Care
VL - 25
IS - 2
N2 - PURPOSE: The purpose of the study was to determine the independent risk factors on mortality in patients with community-acquired severe sepsis and septic shock. METHODS: A single-site prospective cohort study was carried out in a medical-surgical intensive care unit in an academic tertiary care center. One hundred twelve patients with community-acquired bloodstream infection with severe sepsis and septic shock were identified. Clinical, microbiologic, and laboratory parameters were compared between hospital survivors and hospital deaths. RESULTS: One-hundred twelve patients were included. The global mortality rate was 41.9%, 44.5% in septic shock and 34.4% in severe sepsis. One or more comorbidities were present in 66% of patients. The most commonly identified bloodstream pathogens were Escherichia coli (25%) and Staphylococcus aureus (21.4%). The proportion of patients receiving inadequate antimicrobial treatment was 8.9%. By univariate analysis, age, Acute Physiology and Chronic Health Evaluation II score, at least 3 organ dysfunctions, and albumin, but neither microbiologic characteristics nor site of infection, differed significantly between survivors and nonsurvivors. Acute Physiology and Chronic Health Evaluation II (odds ratio, 1.13; 95% confidence interval, 1.06-1.21) and albumin (odds ratio, 0.34; 95% confidence interval, 0.15-0.76) were independent risk factors associated with global mortality in logistic regression analysis. CONCLUSION: In addition to the severity of illness, hypoalbuminemia was identified as the most important prognostic factor in community-acquired bloodstream infection with severe sepsis and septic shock.
SN - 1557-8615
UR - https://www.unboundmedicine.com/medline/citation/20149587/Prognostic_factors_of_mortality_in_patients_with_community_acquired_bloodstream_infection_with_severe_sepsis_and_septic_shock_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-9441(10)00004-3
DB - PRIME
DP - Unbound Medicine
ER -
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