Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection
<h4>Background</h4> <p>Community acquired bloodstream infection (CABSI) in low- and middle income countries is associated with a high mortality. This study describes the clinical manifestations, laboratory findings and correlation of SOFA and qSOFA with mortality in patients with...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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BioMed Central
2018
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| _version_ | 1826306697258336256 |
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| author | Dat, VQ Long, NT Hieu, VN Phuc, NDH Kinh, NV Trung, NV Van Doorn, HR Bonell, A Nadjm, B |
| author_facet | Dat, VQ Long, NT Hieu, VN Phuc, NDH Kinh, NV Trung, NV Van Doorn, HR Bonell, A Nadjm, B |
| author_sort | Dat, VQ |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Community acquired bloodstream infection (CABSI) in low- and middle income countries is associated with a high mortality. This study describes the clinical manifestations, laboratory findings and correlation of SOFA and qSOFA with mortality in patients with CABSI in northern Vietnam.</p> <h4>Methods</h4> <p>This was a retrospective study of 393 patients with at least one positive blood culture with not more than one bacterium taken within 48 h of hospitalisation. Clinical characteristic and laboratory results from the first 24 h in hospital were collected. SOFA and qSOFA scores were calculated and their validity in this setting was evaluated.</p> <h4>Results</h4> <p>Among 393 patients with bacterial CABSI, approximately 80% (307/393) of patients had dysfunction of one or more organ on admission to the study hospital with the most common being that of coagulation (57.1% or 226/393). SOFA performed well in prediction of mortality in those patients initially admitted to the critical care unit (AUC 0.858, 95%CI 0.793–0.922) but poor in those admitted to medical wards (AUC 0.667, 95%CI 0.577–0.758). In contrast qSOFA had poor predictive validity in both settings (AUC 0.692, 95%CI 0.605–0.780 and AUC 0.527, 95%CI 0.424–0.630, respectively). The overall case fatality rate was 28%. HIV infection (HR = 3.145, p = 0.001), neutropenia (HR = 2.442, p = 0. 002), SOFA score 1-point increment (HR = 1.19, p < 0.001) and infection with Enterobacteriaceae (HR = 1.722, p = 0.037) were independent risk factors for in-hospital mortality.</p> <h4>Conclusions</h4> <p>Organ dysfunction was common among Vietnamese patients with CABSI and associated with high case fatality. SOFA and qSOFA both need to be further validated in this setting.</p> |
| first_indexed | 2024-03-07T06:51:54Z |
| format | Journal article |
| id | oxford-uuid:fcd5d99b-800d-4f3b-a7ed-68d021a46371 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:51:54Z |
| publishDate | 2018 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:fcd5d99b-800d-4f3b-a7ed-68d021a463712022-03-27T13:24:05ZClinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infectionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fcd5d99b-800d-4f3b-a7ed-68d021a46371EnglishSymplectic Elements at OxfordBioMed Central2018Dat, VQLong, NTHieu, VNPhuc, NDHKinh, NVTrung, NVVan Doorn, HRBonell, ANadjm, B <h4>Background</h4> <p>Community acquired bloodstream infection (CABSI) in low- and middle income countries is associated with a high mortality. This study describes the clinical manifestations, laboratory findings and correlation of SOFA and qSOFA with mortality in patients with CABSI in northern Vietnam.</p> <h4>Methods</h4> <p>This was a retrospective study of 393 patients with at least one positive blood culture with not more than one bacterium taken within 48 h of hospitalisation. Clinical characteristic and laboratory results from the first 24 h in hospital were collected. SOFA and qSOFA scores were calculated and their validity in this setting was evaluated.</p> <h4>Results</h4> <p>Among 393 patients with bacterial CABSI, approximately 80% (307/393) of patients had dysfunction of one or more organ on admission to the study hospital with the most common being that of coagulation (57.1% or 226/393). SOFA performed well in prediction of mortality in those patients initially admitted to the critical care unit (AUC 0.858, 95%CI 0.793–0.922) but poor in those admitted to medical wards (AUC 0.667, 95%CI 0.577–0.758). In contrast qSOFA had poor predictive validity in both settings (AUC 0.692, 95%CI 0.605–0.780 and AUC 0.527, 95%CI 0.424–0.630, respectively). The overall case fatality rate was 28%. HIV infection (HR = 3.145, p = 0.001), neutropenia (HR = 2.442, p = 0. 002), SOFA score 1-point increment (HR = 1.19, p < 0.001) and infection with Enterobacteriaceae (HR = 1.722, p = 0.037) were independent risk factors for in-hospital mortality.</p> <h4>Conclusions</h4> <p>Organ dysfunction was common among Vietnamese patients with CABSI and associated with high case fatality. SOFA and qSOFA both need to be further validated in this setting.</p> |
| spellingShingle | Dat, VQ Long, NT Hieu, VN Phuc, NDH Kinh, NV Trung, NV Van Doorn, HR Bonell, A Nadjm, B Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
| title | Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
| title_full | Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
| title_fullStr | Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
| title_full_unstemmed | Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
| title_short | Clinical characteristics, organ failure, inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
| title_sort | clinical characteristics organ failure inflammatory markers and prediction of mortality in patients with community acquired bloodstream infection |
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