Predictors for mortality in patients admitted with suspected bacterial infections-A prospective long-term follow-up study

被引:4
作者
Chafranska, Lana [1 ,3 ]
Stenholt, Oscar Overgaard [1 ]
Sorensen, Rune Husas [2 ]
Bin Abdullah, S. M. Osama Bin [2 ]
Nielsen, Finn Erland [1 ]
机构
[1] Copenhagen Univ Hosp, Dept Emergency Med, Frederiksberg, Denmark
[2] Slagelse Hosp, Dept Emergency Med, Slagelse, Denmark
[3] Aalborggade 9,1 tv, DK-2100 Copenhagen, OE, Denmark
关键词
Infectious disease; Emergency department; Emergency medicine; Long-term follow-up; Mortality; Predictors; Bacterial infections; INTERNATIONAL CONSENSUS DEFINITIONS; INFLAMMATORY RESPONSE SYNDROME; COMMUNITY-ACQUIRED PNEUMONIA; SEPTIC SHOCK; HOSPITAL MORTALITY; UNITED-STATES; ORGAN FAILURE; RISK-FACTORS; SEPSIS; CRITERIA;
D O I
10.1016/j.ajem.2022.04.002
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: The aim was to examine predictors for all-cause mortality in a long-term follow-up study of adult patients with infectious diseases of suspected bacterial origin. Methods: A prospective observational study of patients admitted to the emergency department during 1.10.2017-31.03.2018. We used Cox regression to estimate adjusted hazard ratios (aHR) with 95% confidence intervals for mortality. Results: A total of 2110 patients were included (median age 73 years). After a median follow-up of 2.1 years 758 (35.9%, 95% CI 33.9-38.0%) patients had died. Age (aHR1.05; 1.04-1.05), male gender (aHR 1.21; 1.17-1.25), cancer (aHR 1.80; 1.73-1.87), misuse of alcohol (aHR 1.30; 1.22-1.38), if admitted with sepsis within the last year before index admission (aHR 1.56;1.50-1.61), a Sequential Organ Failure Assessment (SOFA) score >_2 (aHR 1.90; 1.83-1.98), SIRS criteria >_2 (aHR 1.23;1.18-1.28) at admission to the ED, length of stay (aHR 1.05; 1.04-1.05) and devices and implants as sources of infection (aHR 7.0; 5.61-8.73) were independently associated with mortality. Skin infections and increasing haemoblobin values reduced the risk of death. Conclusions: More than one-third of a population of patients admitted to the emergency department with infectious diseases of suspected bacterial origin had died during a median follow up of 2.1 years. The study identified several independent predictors for mortality. (c) 2022 Published by Elsevier Inc.
引用
收藏
页码:236 / 243
页数:8
相关论文
共 65 条
[1]   Cigarette smoking and infection [J].
Arcavi, L ;
Benowitz, NL .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (20) :2206-2216
[2]   Trends in infectious disease mortality in the United States during the 20th century [J].
Armstrong, GL ;
Conn, LA ;
Pinner, RW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 281 (01) :61-66
[3]   Prognostic Accuracy of SOFA, qSOFA, and SIRS for Mortality Among Emergency Department Patients with Infections [J].
Bin Abdullah, S. M. Osama ;
Sorensen, Rune Husas ;
Nielsen, Finn Erland .
INFECTION AND DRUG RESISTANCE, 2021, 14 :2763-2775
[4]   Prognostic accuracy of qSOFA in predicting 28-day mortality among infected patients in an emergency department: a prospective validation study [J].
Bin Abdullah, S. M. Osama ;
Sorensen, Rune Husas ;
Dessau, Ram Benny Christian ;
Sattar, Saifullah Muhammed Rafid Us ;
Wiese, Lothar ;
Nielsen, Finn Erland .
EMERGENCY MEDICINE JOURNAL, 2019, 36 (12) :722-+
[5]   DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ .
CHEST, 1992, 101 (06) :1644-1655
[6]   Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score [J].
Brink, Anniek ;
Alsma, Jelmer ;
Verdonschot, Rob Johannes Carel Gerardus ;
Rood, Pleunie Petronella Marie ;
Zietse, Robert ;
Lingsma, Hester Floor ;
Schuit, Stephanie Catherine Elisabeth .
PLOS ONE, 2019, 14 (01)
[7]   Long-term prognosis of septic shock in cancer patients [J].
Camou, Fabrice ;
Didier, Marion ;
Leguay, Thibaut ;
Milpied, Noel ;
Daste, Amaury ;
Ravaud, Alain ;
Mourissoux, Gaelle ;
Guisset, Olivier ;
Issa, Nahema .
SUPPORTIVE CARE IN CANCER, 2020, 28 (03) :1325-1333
[8]   Host Resistance and Immune Responses in Advanced Age [J].
Castle, Steven C. ;
Uyemura, Koichi ;
Fulop, Tamas ;
Makinodan, Takashi .
CLINICS IN GERIATRIC MEDICINE, 2007, 23 (03) :463-+
[9]   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
[10]   Ageing populations: the challenges ahead [J].
Christensen, Kaare ;
Doblhammer, Gabriele ;
Rau, Roland ;
Vaupel, James W. .
LANCET, 2009, 374 (9696) :1196-1208