scholarly journals Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

2019 ◽  
Author(s):  
Yao Chen ◽  
Yanyan Hu ◽  
Jin Zhang ◽  
Yue Shen ◽  
Junling Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Clinical Characteristics ◽  
Immune Status ◽  
Secondary Infection ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Enzyme Linked Immunosorbent Assay ◽  
Infection Group ◽  
Hla Dr

Abstract Background: Secondary infection in hospital was found to have a higher incidence in septic patients and affect clinical outcomes. This study aimed to investigate the clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis. Methods: A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between 2014 January and 2018 January. Data were acquired from medical records. The flow cytometry was performed to measure the CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression. Serum cytokines levels were measured by enzyme-linked immunosorbent assay (ELISA) method. Results: A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 38, 32%). Urinary and deep venous catheterization increased the risk of developing secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital length of stay owing to secondary infection was 4.63 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival curves and Log-rank test revealed secondary infection group had a worse survival between day 15 and day 90. Conclusions: Urinary and deep venous catheter indwelling increased the risk of developing secondary infection. Secondary infection influenced outcomes of septic patients and prolonged in-hospital length of stay. Immunosuppression led to a higher tendency to developing secondary infection. Keywords: Sepsis, Secondary infection, Immunosuppression, HLA-DR, Cytokine

scholarly journals Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study

2019 ◽  
Author(s):  
Yao Chen ◽  
Yanyan Hu ◽  
Jin Zhang ◽  
Yue Shen ◽  
Junling Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Immune Status ◽  
Secondary Infection ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Infection Group ◽  
Acinetobacter Baumanii ◽  
Hla Dr

Abstract Background: Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis. Methods: A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively. Results: A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 ± 1.87 days . Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival analysis and Log-rank test revealed that secondary infection group had worse survival between day 15 and day 90. Conclusions: Urinary and deep venous catheter indwelling increased the risk of developing secondary infection, in which underlying immunosuppression also played a role. Secondary infection affected outcomes of septic patients and prolonged in-hospital length of stay.

scholarly journals Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study

2019 ◽  
Author(s):  
Yao Chen ◽  
Yanyan Hu ◽  
Jin Zhang ◽  
Yue Shen ◽  
Junling Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Immune Status ◽  
Secondary Infection ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Infection Group ◽  
Hla Dr ◽  
Venous Catheterization

Abstract Background : Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis. Methods : A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14 + monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively. Results: A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 ± 1.87 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival analysis and Log-rank test revealed that secondary infection group had worse survival between day 15 and day 90. Conclusions : Urinary and deep venous catheterization increased the risk of secondary infection, in which underlying immunosuppression might also play a role. Secondary infection affected the prognosis of septic patients and prolonged in-hospital length of stay.

scholarly journals Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yao Chen ◽  
Yanyan Hu ◽  
Jin Zhang ◽  
Yue Shen ◽  
Junling Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Immune Status ◽  
Secondary Infection ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Infection Group ◽  
Hla Dr ◽  
Venous Catheterization

Abstract Background Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis. Methods A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively. Results A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 ± 1.87 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival analysis and Log-rank test revealed that secondary infection group had worse survival between day 15 and day 90. Conclusions Urinary and deep venous catheterization increased the risk of secondary infection, in which underlying immunosuppression might also play a role. Secondary infection affected the prognosis of septic patients and prolonged in-hospital length of stay.

scholarly journals Clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis: a retrospective observational study

2019 ◽  
Author(s):  
Yao Chen ◽  
Yanyan Hu ◽  
Jin Zhang ◽  
Yue Shen ◽  
Junling Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Immune Status ◽  
Secondary Infection ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Infection Group ◽  
Acinetobacter Baumanii ◽  
Hla Dr

Abstract Background: Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, prognosis and immune status of secondary infection of sepsis. Methods: A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively. Results: A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection development. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival curves and Log-rank test revealed secondary infection group had a worse survival between day 15 and day 90. Conclusions: Urinary and deep venous catheter indwelling increased the risk of developing secondary infection. Secondary infection influenced outcomes of septic patients and prolonged in-hospital length of stay. Underlying immunosuppression led to a higher tendency to developing secondary infection.

scholarly journals Clinical characteristics and durations of hospitalized patients with COVID-19 in Beijing: a retrospective cohort study

2020 ◽  
Author(s):  
Wen Zhao ◽  
Shikai Yu ◽  
Xiangyi Zha ◽  
Ning Wang ◽  
Qiumei Pang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Ct Scan ◽  
Clinical Characteristics ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Study Endpoint ◽  
Cumulative Probability ◽  
Illness Onset ◽  
Severity Of Disease

AbstractBackgroundCOVID-19 is still becoming an increasing global threat to public health. More detailed and specific characteristics of COVID-19 are needed to better understand this disease. Additionally, durations of COVID-19, e.g., the average time from exposure to recovery, which is of great value in understanding this disease, has not been reported so far.AimsTo give the information on clinical characteristics and different durations of COVID-19 and to identify the potential risk factors for longer hospitalization duration.MethodsIn this retrospective study, we enrolled 77 patients (mean age: 52±20 years; 44.2% males) with laboratory-confirmed COVID-19 admitted to Beijing YouAn Hospital during 21st Jan and 8th February 2020. Epidemiological, clinical and radiological data on admission were collected; complications and outcomes were followed up until 29th February 2020. The study’s endpoint was the discharge within two weeks. Cox proportional-hazards regression was performed to identify risk factors for longer hospitalization duration.ResultsOf 77 patients, there are 34 (44.2%) males, 24 (31.2%) with comorbidities, 22 (28.6%) lymphopenia, 20 (26.0%) categorized as severe patients, and 28 (36.4%) occurred complications. By the end of follow-up, 64 (83.1%) patients were discharged home after being tested negative for SARS-CoV-2 infections, 8 remained in hospital and 5 died. 36 (46.8%) patients were discharged within 14 days and thus reached the study endpoint, including 34 (59.6%) of 57 non-severe patients and 2 (10%) of 20 severe patients. The overall cumulative probability of the endpoint was 48.3%. Hospital length of stay and duration of exposure to discharge for 64 discharged patients were 13 (10-16.5) and 23 (18-24.5) days, respectively. Multivariable stepwise Cox regression model showed bilateral pneumonia on CT scan, shorter time from the illness onset to admission, severity of disease and lymphopenia were independently associated with longer hospitalized duration.ConclusionsCOVID-19 has significantly shorter duration of disease and hospital length of stay than SARS. Bilateral pneumonia on CT scan, shorter period of illness onset to admission, lymphopenia, severity of disease are the risk factors for longer hospitalization duration of COVID-19.

scholarly journals Clinical Characteristics and Durations of Hospitalized Patients with COVID-19 in Beijing: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Zhao Wen
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Ct Scan ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cumulative Probability ◽  
Illness Onset ◽  
End Point

Objective: To provide information on clinical characteristics and different durations of COVID-19 and to identify thepotential risk factors for longer hospitalization of patients with COVID-19.Methods: In this retrospective study, we enrolled 77 patients (age 52 ± 20 years; 44.2% males) with laboratory confirmedCOVID-19 admitted to Beijing YouAn Hospital between January 21 and February 8, 2020. Epidemiological,clinical, and radiological data on admission were collected; complications and outcomes were followed up untilFebruary 26, 2020. The end point of the study was discharge alive within 2 weeks. Cox proportional-hazards regressionwas performed to identify risk factors for longer hospitalization.Results: Of 77 patients, there were 34 males (44.2%), 24 (31.2%) with comorbidities, 22 (28.6%) with lymphopenia,20 (26.0%) with severe COVID-19, and 28 (36.4%) with complications. By the end of follow-up, 64 patients (83.1%)were discharged home, eight remained in hospital, and five had died. Thirty-six patients (46.8%) were dischargedwithin 14 days and thus reached the study end point, including 34 of the 57 patients with nonsevere COVID-19(59.6%) and two of the 20 patients with severe COVID-19 (10%). The overall cumulative probability of the end pointwas 48.3%. Hospital length of stay and the duration from exposure to discharge for the 64 discharged patients were13 (10–16.5) days and 23 (18–24.5) days, respectively. A multivariable stepwise Cox regression model showed thatbilateral pneumonia on CT scan, shorter time from illness onset to admission, severity of disease, and lymphopeniawere independently associated with longer hospitalization.Conclusions: COVID-19 has a shorter duration of disease and hospital length of stay than severe acute respiratorysyndrome. Bilateral pneumonia on CT scan, shorter period from illness onset to admission, lymphopenia, and severityof disease are the risk factors for longer hospitalization of patients with COVID-19.

scholarly journals Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anping Guo ◽  
Jin Lu ◽  
Haizhu Tan ◽  
Zejian Kuang ◽  
Ying Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Liver Disease ◽  
Length Of Stay ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Hospital Length ◽  
Clinical Treatment ◽  
Hospital Length Of Stay ◽  
Female Sex

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.

Infections Acquired by Adults Who Receive Extracorporeal Membrane Oxygenation Risk Factors and Outcome

2013 ◽  
Vol 34 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Cecile Aubron ◽  
Allen C. Cheng ◽  
David Pilcher ◽  
Tim Leong ◽  
Geoff Magrin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Extracorporeal Membrane Oxygenation ◽  
Unit Length ◽  
Severity Of Illness ◽  
Infectious Complications ◽  
Hospital Length ◽  
Interquartile Range ◽  
Hospital Length Of Stay ◽  
Membrane Oxygenation

Objectives.To analyze infectious complications that occur in patients who receive extracorporeal membrane oxygenation (ECMO), associated risk factors, and consequences on patient outcome.Design.Retrospective observational survey from 2005 through 2011.Participants and Setting.Patients who required ECMO in an Australian referral center.Methods.Cases of bloodstream infection (BSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (YAP) that occurred in patients who received ECMO were analyzed.Results.A total of 146 ECMO procedures were performed for more than 48 hours in 139 patients, and 36 patients had a total of 46 infections (30.1 infectious episodes per 1,000 days of ECMO). They included 24 cases of BSI, 6 of them secondary to VAP; 23 cases of VAP; and 5 cases of CAUTI. The most frequent pathogens were Enterobacteriaceae (found in 16 of 46 cases), and Candida was the most common cause of BSI (in 9 of 24 cases). The Sequential Organ Failure Assessment score before ECMO initiation and the number of days of support were independenuy associated with a risk of BSI, with odds ratios of 1.23 (95% confidence interval [CI], 1.03-1.47; P = .019) and 1.08(95% CI, 1.03-1.19]; P = .006), respectively. Infected patients did not have a significantly higher mortality compared with uninfected patients (41.7% vs 32%; P = .315), but intensive care unit length of stay (16 days [interquartile range, 8-26 days] vs 11 days [IQR, 4-19 days]; P = .012) and hospital length of stay (33.5 days [interquartile range, 15.5-55.5] vs 24 days [interquartile range, 9-42 days]; P = .029) were longer.Conclusion.The probability of infection increased with the duration of support and the severity of illness before initiation of ECMO. Infections affected length of stay but did not have an impact on mortality.

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