Bacteraemia and quick Sepsis Related Organ Failure Assessment (qSOFA) are independent risk factors for long-term mortality in very elderly patients with suspected infection: retrospective cohort study

Hernández-Quiles, Rubén; Merino-Lucas, Esperanza; Boix, Vicente; Fernández-Gil, Adela; Rodríguez-Díaz, Juan Carlos; Gimeno, Adelina; Valero, B.; Sánchez-Martínez, Rosario; Ramos‐Rincón, José‐Manuel

doi:10.1186/s12879-022-07242-4

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…This supports the use of simple clinical data in the study of infections. However, no other vital signs that were related to bacteremia in other studies, such as heart rate >90 rpm [20] or systolic blood pressure <100 mmHg [22,38], were found in this study.…”

Section: Discussioncontrasting

confidence: 89%

“…Bacteremia from different sources has been related to severity and mortality in some studies [ 38 , 48 ], but its role in UTIs remains controversial. Some studies show an association between bacteremia from community-acquired UTIs and septic shock [ 12 , 49 , 50 ] or mortality [ 51 ], while others show no influence on outcomes [ 10 , 24 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Bacteremia and Its Clinical Impact on Complicated Community-Acquired Urinary Tract Infection

et al. 2023

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Bacteremia has been associated with severity in some infections; however, its impact on the prognosis of urinary tract infections (UTIs) is still disputed. Our goal is to determine the risk factors for bacteremia and its clinical impact on hospitalized patients with complicated community-acquired urinary tract infections. We conducted a prospective observational study of patients admitted to the hospital with complicated community-acquired UTIs. Clinical variables and outcomes of patients with and without bacteremia were compared, and multivariate analysis was performed to identify risk factors for bacteremia and mortality. Of 279 patients with complicated community-acquired UTIs, 37.6% had positive blood cultures. Risk factors for bacteremia by multivariate analysis were temperature ≥ 38 °C (p = 0.006, OR 1.3 (95% CI 1.1–1.7)) and procalcitonin ≥ 0.5 ng/mL (p = 0.005, OR 8.5 (95% CI 2.2–39.4)). In-hospital and 30-day mortality were 9% and 13.6%, respectively. Quick SOFA (p = 0.030, OR 5.4 (95% CI 1.2–24.9)) and Barthel Index <40% (p = 0.020, OR 4.8 (95% CI 1.3–18.2)) were associated with 30-day mortality by multivariate analysis. However, bacteremia was not associated with 30-day mortality (p = 0.154, OR 2.7 (95% CI 0.7–10.3)). Our study found that febrile community-acquired UTIs and elevated procalcitonin were risk factors for bacteremia. The outcomes in patients with bacteremia were slightly worse, but without significant differences in mortality.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Bacteremia and Its Clinical Impact on Complicated Community-Acquired Urinary Tract Infection

et al. 2023

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“…This highlights sepsis as a significant contributor to the worldwide disease burden ( 5 ). The incidence of sepsis among elderly patients has risen sharply due to the increasing aging population ( 6 , 7 ), placing this demographic at a high risk of mortality. Importantly, sepsis is a leading cause of morbidity and death in older patients ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Association between geriatric nutritional risk index and 28 days mortality in elderly patients with sepsis: a retrospective cohort study

Li,

Lu,

Qin

et al. 2023

Front. Med.

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BackgroundThere is a significant controversy surrounding the impact of the geriatric nutritional risk index (GNRI) on mortality among elderly septic patients. This retrospective cohort study aimed to investigate the association between GNRI at admission and 28 days mortality in elderly septic patients.MethodsWe retrospectively analyzed data collected from the MIMIC IV database between 2009 and 2019, which included 2,834 septic patients aged 65 years and above. The exposure variable was the GNRI, determined according to albumin levels, height, and weight. The primary outcome was 28 days mortality. We employed multivariable Cox regression analyses and Kaplan–Meier survival curves to examine the association between GNRI and 28 days mortality. We used restricted cubic splines to determine if there was a non-linear relationship between 28 days mortality and GNRI in elderly patients with sepsis and to examine the presence of a threshold saturation effect. In addition, interaction tests were conducted to identify subgroups that exhibited significant differences.ResultsA total of 2,834 elderly patients with sepsis participated in the study. Following adjustment, multivariable Cox regression analyses demonstrated that the GNRI was related to 28 days mortality (HR = 0.97, p < 0.001, 95% CI: 0.97–0.98). An L-shaped connection between GNRI and 28 days mortality was discovered via restricted cubic spline analysis, with an inflection point of 98.1. On the left side of the inflection point, GNRI levels were significantly negatively linked with 28 days mortality (HR = 0.967, 95% CI: 0.959–0.974; p < 0.001), and on the right side, there was no significant correlation (HR = 1.043, 95% CI: 0.984–1.106; p = 0.1549).ConclusionIn this analysis of data from a large cohort of elderly septic patients, GNRI scores on admission were correlated with a 28 days risk of death from sepsis in the elderly suggesting that GNRI scores could serve as a valuable indicator for evaluating mortality rates among elderly septic patients in the intensive care unit (ICU).

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“…Furthermore, bacteremia's course in older individuals is typically stealthy, with less apparent clinical symptoms. This leads to poor prognosis and increased mortality, so early detection and intervention are critical for this population [3] .…”

Section: Introductionmentioning

confidence: 99%

Bacterial distribution and predictive value of blood routine parameters in elderly patients with bacteremia: a cross-sectional study

Zhang,

Zhuo,

et al. 2023

Preprint

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to assess the distribution of bacteremia pathogens in elderly patients, to evaluate the impact of gender on pathogen distribution, and to determine the predictive value of routine blood parameters for diagnosing bacteremia. Methods: A total of 151 elderly patients (≥60 years old) who admitted to hospital from October 2022 to June 2023 were retrospectively studied. Routine blood test and blood culture were performed. ROC curve was used to analyze the diagnostic efficacy of blood routine parameters: white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red blood cell distribution width (RDW). Results: The subjects were categorized into either the culture-positive group (82 cases) and the culture-negative one (69 cases) according to blood culture results. There were no significant differences in age and gender between groups. The primary bacterial pathogens of bacteremia in the elderly were Escherichia coli, Klebsiella pneumoniae and Streptococcus. A significantly higher culture positivity rate for E. coli was found in elderly female patients compared to their male counterparts (P = 0.021). The area under the ROC curve of four parameters was: WBC, 0.851 (95% confidence interval (CI) 0.790 - 0.912); NLR, 0.919 (95% CI 0.875 - 0.963); PLR, 0.609 (95% CI 0.518 - 0.700); and RDW was 0.626 (95% CI 0.563 - 0.717). Conclusion: The most frequently pathogenic microorganism causing bacteremia was E. coli, with elderly female patients having a significantly higher rate of culture positivity. Routine blood parameters (WBC, NLR, PLR, and RDW) demonstrated predictive potential for bacteremia in elderly patients.

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Bacteraemia and quick Sepsis Related Organ Failure Assessment (qSOFA) are independent risk factors for long-term mortality in very elderly patients with suspected infection: retrospective cohort study

Cited by 8 publications

References 27 publications

Risk Factors for Bacteremia and Its Clinical Impact on Complicated Community-Acquired Urinary Tract Infection

Risk Factors for Bacteremia and Its Clinical Impact on Complicated Community-Acquired Urinary Tract Infection

Association between geriatric nutritional risk index and 28 days mortality in elderly patients with sepsis: a retrospective cohort study

Bacterial distribution and predictive value of blood routine parameters in elderly patients with bacteremia: a cross-sectional study

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