scholarly journals Risk Factors and Clinical Characteristics of Catheter Line-associated Bloodstream Infection in MIMIC IV Database

2021 ◽  
Author(s):  
Fang Li ◽  
Fan Lu ◽  
Luming Zhang ◽  
Longzhu Li ◽  
Mingyao Xing ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Bloodstream Infection ◽  
Clinical Characteristics ◽  
Medical Information ◽  
Statistical Significance ◽  
Femoral Vein ◽  
General Information ◽  
Penicillin G ◽  
Research Database

Abstract Background: Central line-associated bloodstream infection (CLABSI) is a common hospital infection. The increasing use of peripherally inserted central catheters and fully implanted venous ports, data on the epidemiological and clinical characteristics of CLABSI in the overall central venous catheter (CVC) population remain limited. The Medical Information Mart for Intensive Care (MIMIC IV) database is a free, open, and public resource research database. The purpose of this study was to describe the risk factors and clinical characteristics of CLABSI in MIMIC IV.Methods: A total of 31,116 patients were included in this study. General information, CVC-related information, comorbidity information, microbiological information, and antibiotic use information were extracted to describe and analyze the clinical characteristics of patients with CLABSI.Results: According to the occurrence of CLABSI, 31,116 patients were divided into the NO CLABSI group (n=30,395) and CLABSI group (n=721). The total indwelling duration of CVC was 439,239.6 days, The incidence of CLABSI is 2.32% and 1.64/1000 catheter days. The risk factors for CLABSI were the number of CVC type, duration of CVC, number of antibiotic type, duration of antibiotics, and femoral vein and internal jugular vein intubation. The in-hospital mortality of the CLABSI group was higher than that of the NO CLABSI group, but no statistical significance was observed (P>0.05). Gram-positive (G+) cocci and Gram-negative (G-) bacilli accounted for 80% and 16.93% of positive bacteria in catheter culture. G+ cocci and G- bacilli accounted for 59.45% and 25.62% of positive bacteria in blood culture. Drugs with the highest resistance rates in catheter culture included penicillin G benzathine, oxacillin, and erythromycin. The most commonly used antibiotics for the treatment of CLABSI included vancomycin, cefepime, piperacillin tazobactam, and cefazolin.Conclusions: This study investigated independent risk factors for CLABSI and their association with in-hospital mortality and described the etiological characteristics, drug sensitivity, and the distribution of antibiotics used for treatment.

scholarly journals Polymicrobial Bloodstream Infection in Neonates: Microbiology, Clinical Characteristics, and Risk Factors

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e83082 ◽  
Author(s):  
Ming-Horng Tsai ◽  
Shih-Ming Chu ◽  
Jen-Fu Hsu ◽  
Reyin Lien ◽  
Hsuan-Rong Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Clinical Characteristics

scholarly journals Risk of Obstructive Sleep Apnea and Its Association with Cardiovascular and Noncardiac Vascular Risk in Patients with Rheumatoid Arthritis: A Population-based Study

2017 ◽  
Vol 45 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Katelynn M. Wilton ◽  
Eric L. Matteson ◽  
Cynthia S. Crowson
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Medical Information ◽  
Statistical Significance ◽  
Vascular Events ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Large Joint

Objective.To define the incidence of obstructive sleep apnea (OSA) in patients with rheumatoid arthritis (RA) and determine whether OSA diagnosis predicts future cardiovascular disease (CVD) and noncardiac vascular events.Methods.Medical information pertaining to RA, OSA, CVD, and vascular diagnoses was extracted from a comprehensive medical record system for a geographically defined population of 813 patients previously diagnosed with RA and 813 age- and sex-matched comparator subjects.Results.The risk for OSA in persons with RA versus comparators was elevated, although not reaching statistical significance (HR 1.32, 95% CI 0.98–1.77; p = 0.07). Patients with RA were more likely to be diagnosed with OSA if they had traditional risk factors for OSA, including male sex, current smoking status, hypertension, diabetes, dyslipidemia, and increased body mass index. Features of RA disease associated with OSA included large joint swelling and joint surgery. Patients with RA with decreased renal function were also at higher risk of OSA. The increased risk of overall CVD among patients with RA who have OSA was similar to the increased CVD risk associated with OSA in the comparator cohort (interaction p = 0.86). OSA diagnosis was associated with an increased risk of both CVD (HR 1.9, 95% CI 1.08–3.27), and cerebrovascular disease (HR 2.4, 95% CI 1.14–5.26) in patients with RA.Conclusion.Patients with RA may be at increased risk of OSA secondary to both traditional and RA-related risk factors. Diagnosis with OSA predicts future CVD in RA and may provide an opportunity for CVD intervention.

scholarly journals Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain

2020 ◽  
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Verónica Buonaiuto ◽  
Michele Ricci ◽  
Jesica Martín-Carmona ◽  
Diana Paredes-Ruíz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Atherosclerotic Cardiovascular Disease ◽  
X Rays ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Male Sex

Abstract Background Advanced age is a well-known risk factor for poor prognosis in COVID-19. However, few studies have specifically focused on very old inpatients with COVID-19. This study aims to describe the clinical characteristics of very old inpatients with COVID-19 and identify risk factors for in-hospital mortality at admission. Methods We conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years hospitalized with COVID-19 in 150 Spanish hospitals (SEMI-COVID-19) Registry (March 1–May 29, 2020). The primary outcome was in-hospital mortality. A uni- and multivariate logistic regression was performed to assess predictors of mortality at admission. Results A total of 2772 consecutive patients (49.4% men, median age 86.3 years) were analyzed. Rates of atherosclerotic cardiovascular disease, diabetes mellitus, dementia, and Barthel Index < 60 were 30.8%, 25.6%, 30.5%, and 21.0%, respectively. The overall case-fatality rate was 46.9% (n: 1301) and increased with age (80–84 years: 41.6%; 85–90 years: 47.3%; 90–94 years: 52.7%; ≥95 years: 54.2%). After analysis, male sex and moderate-to-severe dependence were independently associated with in-hospital mortality; comorbidities were not predictive. At admission, independent risk factors for death were: oxygen saturation < 90%; temperature ≥ 37.8°C; quick sequential organ failure assessment (qSOFA) score ≥ 2; and unilateral–bilateral infiltrates on chest x-rays. Some analytical findings were independent risk factors for death, including estimated glomerular filtration rate < 45 mL/min/1.73 m2; lactate dehydrogenase ≥ 500 U/L; C-reactive protein ≥ 80 mg/L; neutrophils ≥ 7.5 × 103/μL; lymphocytes < 0.8 × 103/μL; and monocytes < 0.5 × 103/μL. Conclusions This first large, multicenter cohort of very old inpatients with COVID-19 shows that age, male sex, and poor preadmission functional status—not comorbidities—are independently associated with in-hospital mortality. Severe COVID-19 at admission is related to poor prognosis.

Propensity-Score Analysis Reveals that Sex is Not a Prognosis Factor for Mortality in Intensive Care Unit-Admitted Patients with Sepsis

2021 ◽  
Author(s):  
Manuel Ponce-Alonso ◽  
Borja M Fernández-Félix ◽  
Ana Halperin ◽  
Mario Rodríguez-Domínguez ◽  
Ana M Sánchez-Díaz ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Propensity Score Analysis ◽  
Statistical Significance ◽  
Prognostic Score ◽  
Score Analysis ◽  
Infection Source ◽  
Comorbidity Index ◽  
Univariate Analyses

Abstract Purpose: Classically, men have been considered to have a higher incidence of infectious diseases, with controversy over the possibility that sex could condition the prognosis of the infection. The aim of the present work was to explore this assumption in patients admitted to the ICU with sepsis using a robust statistical analysis.Methods: Retrospective analysis (2006-2017) in patients with microbiologically confirmed bacteremia (n=440) by majoritarian bacterial pathogens. Risk of ICU and in-hospital mortality in males respect to females was compared by an univariant analysis and a propensity score correspondence analysis integrating their clinical characteristics. Results: Relevant differences were related to the infection source: urinary origin for females (28.7% vs 19.8%) and abdominopelvic surgery for males (8.8% vs 4.8%). Sepsis occurred more frequently in males (80.2% vs 76.1%) as well as in-hospital (48.0% vs 41.3%) and ICU (39.9% vs 36.5%) mortality. Escherichia coli was 2 times more frequent in survivors whereas Staphylococcus aureus was 3 times more frequent in deceased patients. Univariate analyses showed that males had a higher Charlson comorbidity index, a poorer McCabe prognostic score; however the propensity score in 296 patients demonstrated that females had higher risk of both ICU (OR 0.72; 95% CI 0.46 to 1.13), and in-hospital mortality (OR 0.84; 95% CI 0.55 to 1.30) but without statistical significance. Conclusion: Men with sepsis have worse clinical characteristics when admitted to the ICU, but sex has no influence on the prognosis of mortality. Our data contributes to help reduce the sex-dependent gap present in health care provision.

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