Bacteremia is associated with excess long-term mortality: A 12-year population-based cohort study

被引:44
作者
Nielsen, Stig Lonberg [1 ]
Lassen, Annmarie Touborg [2 ]
Gradel, Kim Oren [3 ,4 ]
Jensen, Thoger Gorm [5 ]
Kolmos, Hans Jorn [5 ]
Hallas, Jesper [6 ]
Pedersen, Court [1 ]
机构
[1] Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense C, Denmark
[2] Odense Univ Hosp, Dept Emergency Med, DK-5000 Odense C, Denmark
[3] Odense Univ Hosp, Ctr Clin Epidemiol, DK-5000 Odense C, Denmark
[4] Univ Southern Denmark, Inst Clin Res, Res Unit Clin Epidemiol, DK-5230 Odense M, Denmark
[5] Odense Univ Hosp, Dept Clin Microbiol, DK-5000 Odense C, Denmark
[6] Univ Southern Denmark, Res Unit Clin Pharmacol, DK-5000 Odense C, Denmark
关键词
Bacteremia; Epidemiology; Mortality; Population-based; Causes of death; BLOOD-STREAM INFECTION; HEMATOLOGICAL MALIGNANCIES; DANISH; SEPSIS; SURVEILLANCE; COMORBIDITY; DEFINITION; PREDICTOR; MAGNITUDE; SURVIVAL;
D O I
10.1016/j.jinf.2014.08.012
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: Little is known about long-term outcomes following bacteremia. We investigated long-term mortality and causes of death among bacteremia patients compared with population controls. Methods: Population-based cohort study of bacteremia patients and population controls matched on sex, year of birth, residency and calendar time, in Denmark during 2000-2008. We calculated absolute mortality and adjusted mortality rate ratios (MRRs) in predefined follow-up periods. Results: The absolute mortality for bacteremia patients (n = 7783) and population controls (n = 38,906) was 22.0% vs. 0.2% (30 days), 41.4% vs. 2.6% (1 year) and 75.8% vs. 36.6% (10 years). For bacteremia patients, the MRR was 115.3 (95% CI, 88.2-150.9) 0-30 days after bacteremia and 2.1 (95% CI, 1.8-2.3) from 5 years to end of follow-up. The most common causes of death were cancer and cardiovascular diseases. Within one year of bacteremia, the relative risk of death was highest for genitourinary diseases and infectious diseases. Among one-year survivors of bacteremia, the relative risk of death was increased for all major causes of death. Conclusions: Bacteremia is associated with a poor prognosis and considerable excess long-term mortality compared with the general population. The most common causes of death after bacteremia are cancer and cardiovascular diseases. Summary: This population-based cohort study reports an excess long-term mortality among 7783 bacteremia patients compared with matched population controls during 12 years of follow-up. We identified patients in particular risk of death and reported novel information on causes of death. (C) 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:111 / 126
页数:16
相关论文
共 31 条
[1]   Competing risks in epidemiology: possibilities and pitfalls [J].
Andersen, Per Kragh ;
Geskus, Ronald B. ;
de Witte, Theo ;
Putter, Hein .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2012, 41 (03) :861-870
[2]   HOW BAD ARE BACTEREMIA AND SEPSIS - OUTCOMES IN A COHORT WITH SUSPECTED BACTEREMIA [J].
BATES, DW ;
PRUESS, KE ;
LEE, TH .
ARCHIVES OF INTERNAL MEDICINE, 1995, 155 (06) :593-598
[3]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[4]  
Gaist D, 1997, DAN MED BULL, V44, P445
[5]   The Danish Cancer Registry [J].
Gjerstorff, Marianne Lundkjaer .
SCANDINAVIAN JOURNAL OF PUBLIC HEALTH, 2011, 39 :42-45
[6]   Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe [J].
Goto, M. ;
Al-Hasan, M. N. .
CLINICAL MICROBIOLOGY AND INFECTION, 2013, 19 (06) :501-509
[7]   Magnitude of bacteraemia is a predictor of mortality during 1 year of follow-up [J].
Gradel, K. O. ;
Sogaard, M. ;
Dethlefsen, C. ;
Nielsen, H. ;
Schonheyder, H. C. .
EPIDEMIOLOGY AND INFECTION, 2009, 137 (01) :94-101
[8]   Classification of positive blood cultures: computer algorithms versus physicians' assessment - development of tools for surveillance of bloodstream infection prognosis using population-based laboratory databases [J].
Gradel, Kim O. ;
Knudsen, Jenny Dahl ;
Arpi, Magnus ;
Ostergaard, Christian ;
Schonheyder, Henrik C. ;
Sogaard, Mette .
BMC MEDICAL RESEARCH METHODOLOGY, 2012, 12
[9]   CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting [J].
Horan, Teresa C. ;
Andrus, Mary ;
Dudeck, Margaret A. .
AMERICAN JOURNAL OF INFECTION CONTROL, 2008, 36 (05) :309-332
[10]  
Juel K, 1999, DAN MED BULL, V46, P354