Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study
Abstract Background The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD). Methods We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-07-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05211-3 |
| _version_ | 1818240772566155264 |
|---|---|
| author | Hans Kristian Floeystad Jacob Dag Berild Bjoern Jardar Brandsaeter Didrik Frimann Vestrheim Dag Berild Are Martin Holm |
| author_facet | Hans Kristian Floeystad Jacob Dag Berild Bjoern Jardar Brandsaeter Didrik Frimann Vestrheim Dag Berild Are Martin Holm |
| author_sort | Hans Kristian Floeystad |
| collection | DOAJ |
| description | Abstract Background The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD). Methods We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993 to 2008. Clinical data were registered. Survival data were retrieved from official registries. We used Cox regression and Kaplan-Meier curve to compare mortality within 28 days of admission in patients with and without GI symptoms. Results Four hundred sixteen patients were included. Of these, 108 patients (26%) presented with GI symptoms, and 47 patients (11%) with GI symptoms only. Patients with GI symptoms were younger (p < 0.001) and had less cardiovascular disease (p < 0.001), pulmonary disease (p = 0.048), and cancer (p = 0.035) and received appropriate antibiotic treatment later. After adjusting for risk factors, we found an increased hazard ratio of 2.28 (95% CI 1.31–3.97) in patients presenting with GI symptoms. In patients with GI symptoms only there was an increased hazard ratio of 2.24 (95% CI 1.20–4.19) in univariate analysis, which increased to 4.20 (95% CI 2.11–8.39) after multivariate adjustment. Fewer patients with GI symptoms only received antibiotics upon admission. Conclusions A large proportion of IPD patients present with GI symptoms only or in combination with other symptoms. GI symptoms in IPD are associated with increased short-term mortality. |
| first_indexed | 2024-12-12T13:18:45Z |
| format | Article |
| id | doaj.art-dc651a3833dc41c29c57f64e6c2464fc |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T13:18:45Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-dc651a3833dc41c29c57f64e6c2464fc2022-12-22T00:23:22ZengBMCBMC Infectious Diseases1471-23342020-07-012011810.1186/s12879-020-05211-3Gastrointestinal symptoms in invasive pneumococcal disease: a cohort studyHans Kristian Floeystad0Jacob Dag Berild1Bjoern Jardar Brandsaeter2Didrik Frimann Vestrheim3Dag Berild4Are Martin Holm5Department of Internal Medicine, Sorlandet HospitalNorwegian Institute of Public Health, Division of infection control and environmental healthDepartment of Internal Medicine, Lovisenberg HospitalNorwegian Institute of Public Health, Division of infection control and environmental healthDepartment of Infectious Disease, Oslo University HospitalInstitute of Clinical Medicine, Faculty of Medicine, University of OsloAbstract Background The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD). Methods We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993 to 2008. Clinical data were registered. Survival data were retrieved from official registries. We used Cox regression and Kaplan-Meier curve to compare mortality within 28 days of admission in patients with and without GI symptoms. Results Four hundred sixteen patients were included. Of these, 108 patients (26%) presented with GI symptoms, and 47 patients (11%) with GI symptoms only. Patients with GI symptoms were younger (p < 0.001) and had less cardiovascular disease (p < 0.001), pulmonary disease (p = 0.048), and cancer (p = 0.035) and received appropriate antibiotic treatment later. After adjusting for risk factors, we found an increased hazard ratio of 2.28 (95% CI 1.31–3.97) in patients presenting with GI symptoms. In patients with GI symptoms only there was an increased hazard ratio of 2.24 (95% CI 1.20–4.19) in univariate analysis, which increased to 4.20 (95% CI 2.11–8.39) after multivariate adjustment. Fewer patients with GI symptoms only received antibiotics upon admission. Conclusions A large proportion of IPD patients present with GI symptoms only or in combination with other symptoms. GI symptoms in IPD are associated with increased short-term mortality.http://link.springer.com/article/10.1186/s12879-020-05211-3Invasive pneumococcal diseaseSepsisPneumococcal bacteremiaGastrointestinal symptomsMortality |
| spellingShingle | Hans Kristian Floeystad Jacob Dag Berild Bjoern Jardar Brandsaeter Didrik Frimann Vestrheim Dag Berild Are Martin Holm Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study BMC Infectious Diseases Invasive pneumococcal disease Sepsis Pneumococcal bacteremia Gastrointestinal symptoms Mortality |
| title | Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study |
| title_full | Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study |
| title_fullStr | Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study |
| title_full_unstemmed | Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study |
| title_short | Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study |
| title_sort | gastrointestinal symptoms in invasive pneumococcal disease a cohort study |
| topic | Invasive pneumococcal disease Sepsis Pneumococcal bacteremia Gastrointestinal symptoms Mortality |
| url | http://link.springer.com/article/10.1186/s12879-020-05211-3 |
| work_keys_str_mv | AT hanskristianfloeystad gastrointestinalsymptomsininvasivepneumococcaldiseaseacohortstudy AT jacobdagberild gastrointestinalsymptomsininvasivepneumococcaldiseaseacohortstudy AT bjoernjardarbrandsaeter gastrointestinalsymptomsininvasivepneumococcaldiseaseacohortstudy AT didrikfrimannvestrheim gastrointestinalsymptomsininvasivepneumococcaldiseaseacohortstudy AT dagberild gastrointestinalsymptomsininvasivepneumococcaldiseaseacohortstudy AT aremartinholm gastrointestinalsymptomsininvasivepneumococcaldiseaseacohortstudy |