Obesity and smoking are factors associated with poor prognosis in patients with bacteraemia
Obesity and smoking are factors associated with poor prognosis in patients with bacteraemia
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DOI：
10.1186/1471-2334-7-13
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发表时间：
2007-03-09
影响因子：
3.7
通讯作者：
Syrjaenen, Jaana
中科院分区：
文献类型：
--
作者：
Huttunen, Reetta;Laine, Janne;Syrjaenen, Jaana
背景：菌血症仍然是所有年龄组病死的主要原因。我们的目的是确定构成菌血症患者病死率的危险因素的主要基础条件。方法：研究涉及149例（79名男性和70名女性）由金黄色葡萄球菌（S。金黄色葡萄球菌）（41名患者）、肺炎链球菌（肺炎链球菌）（42名患者）、β-溶血性链球菌（β-hml str.）(23患者）和土栖性大肠杆菌（E.大肠杆菌感染43例。基础疾病、酒精和烟草消费以及身体质量指数（BMI）都进行了登记。在入院时、连续6天和第10-14天登记实验室检查结果和临床数据。在血培养阳性后30天内研究病死率。结果：19例（12.8%）患者死于菌血症，其中11例（12.8%）患者死于菌血症。我们发现肥胖（p = 0.002，RR 9.8; 95% CI 2.3 - 41.3），吸烟（p < 0.001，RR 16.9; 95% CI 2.1 - 133.5），酗酒（p = 0.008，RR 3.9; 95% CI 1.3 - 11.28），COPD在单变量模型中，类风湿性关节炎（p = 0.01，RR 8.4; 95% CI 1.9至37.1）和类风湿性关节炎（p = 0.045，RR 5.9; 95% CI 1.2至28.8）与菌血症的病死率显著相关。死亡者的中位BMI显著高于幸存者（33 vs. 26，p = 0.003）。肥胖和吸烟也仍然是病例死亡的独立危险因素时，他们的影响一起研究在一个多变量模型调整酒精滥用，年龄（连续变量），性别和致病organis.Conclusion的影响：我们的研究结果表明，肥胖和吸烟是显着的危险因素，在菌血症患者的病死率。确定菌血症致死性结局的潜在危险因素可能使预防措施针对可能获得最大潜在获益的个体。
Background: Bacteraemia is still a major cause of case fatality in all age groups. Our aim was to identify the major underlying conditions constituting risk factors for case fatality in bacteraemia patients.Methods: The study involved 149 patients (79 male and 70 female) with bacteraemia caused by Staphylococcus aureus (S. aureus) (41 patients), Streptococcus pneumoniae (Str. pneumoniae) (42 patients), beta-hemolytic streptococcae (beta-hml str.) (23 patients) and Eschericia coli (E. coli) (43 patients). Underlying diseases, alcohol and tobacco consumption and body mass index (BMI) were registered. Laboratory findings and clinical data were registered on admission and 6 consecutive days and on day 10-14. Case fatality was studied within 30 days after positive blood culture. Associations between underlying conditions and case fatality were studied in univariate analysis and in a multivariate model.Results: Nineteen patients (12.8%) died of bacteraemia. We found obesity (p = 0.002, RR 9.8; 95% CI 2.3 to 41.3), smoking (p < 0.001, RR 16.9; 95% CI 2.1 to 133.5), alcohol abuse (p = 0.008, RR 3.9; 95% CI 1.3 to 11.28), COPD (p = 0.01, RR 8.4; 95% CI 1.9 to 37.1) and rheumatoid arthritis (p = 0.045, RR 5.9; 95% CI 1.2 to 28.8) to be significantly associated with case fatality in bacteraemia in univariate model. The median BMI was significantly higher among those who died compared to survivors (33 vs. 26, p = 0.003). Obesity and smoking also remained independent risk factors for case fatality when their effect was studied together in a multivariate model adjusted with the effect of alcohol abuse, age (continuos variable), sex and causative organism.Conclusion: Our results indicate that obesity and smoking are prominent risk factors for case fatality in bacteraemic patients. Identification of risk factors underlying fatal outcome in bacteraemia may allow targeting of preventive efforts to individuals likely to derive greatest potential benefit.