Incidencia y mortalidad de bacteriemia en un hospital clínico docente en Santiago de Chile / Incidence and mortality of bacteremia in a public hospital in Santiago
Rev. méd. Chile
;
140(7): 859-866, jul. 2012. ilus
Article
in Spanish
| LILACS
| ID: lil-656356
ABSTRACT
Background:The incidence of bacteremia has increased over the last decade due to the aging of the population and the wide implementation of invasive nosocomial procedures and wide-spectrum antimicrobial treatments. Aim: To assess the epidemiology of hospital and ambulatory bacteremias in a public hospital in Santiago. Material and Methods: A prospective longitudinal cohort study of laboratory-confirmed adult patients with bacteremia was undertaken at a public hospital in Santiago, between June 1, 2007 and April 30, 2008. Demographic, clinical, and laboratory data was collected into a standardized study-specific form. Results: In the study period, 253 cases of true bacteremia were identified, with an incidence of 11 per 1,000 patient discharges (63.6% nosocomial, 36.7% fatal). Only 2/3 of the cohort was alive at day 28 of hospitalization. Variables associated with mortality were age with a hazard ratio (HR) of 2.31; (95% confidence intervals (CI) 1.42- 3.77); female gender (HR, 1.70; 95% CI 1.06- 2.71); shock (HR, 3.24; 95%CI 2.01-5.22); and C reactive protein (HR, 2.10; 95% CI 1.17- 3.78). The variable associated with lower mortality was surgery (HR, 0.43; 95% CI 0.25-0.75). Selective empiric treatment did not improve survival. Conclusions: Besides age and gender, survival can be influenced by modifiable variables such as presence of shock and surgical intervention, which may provide an opportunity to improve outcomes.
Full text:
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Index:
LILACS (Americas)
Main subject:
Bacteremia
/
Hospitalization
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2012
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Complejo Asistencial Barros Luco Trudeau/CL
/
Universidad de los Andes/CL
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