title: Long-term survival following bacteremia or fungemia.
abstract: OBJECTIVE
  To delineate long-term survival after an episode of bacteremia or fungemia and risk factors for mortality.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  A 900-bed university hospital in Israel.
  
  
  METHODS
  Study group comprising 1991 patients 18 years of age or older in whom bacteremia or fungemia were detected between March 1988 and October 1992, and a control group comprising 1991 inpatients without any infectious diseases, matched for age, sex, department, date of admission, and underlying disorders.
  
  
  METHODS
  None.
  
  
  METHODS
  Interval from the date of the first positive blood culture (study group) or from date of the identical hospital day (in the matched control patient) to the date of death as recorded in the Israeli National Population registry or, if alive, to June 1, 1994.
  
  
  RESULTS
  The median age of patients was 72 years. In the study group, the mortality rate was 26% at 1 month, 43% at 6 months, 48% at 1 year, and 63% at 4 years, and the median survival was 16.2 months. In the control group, the mortality rate was 7% at 1 month, 27% at 1 year, and 42% at 4 years, and the median survival was greater than 75 months (P < .001). Factors significantly and independently associated with mortality in bacteremic patients were functional class (median survival, 0.5 month in bedridden patients), septic shock (median survival, 0.2 month), serum albumin (median survival, 1.1 months in the lowest quartile), serum creatinine (median survival, 2.9 months in the highest quartile), age (median survival, 2.9 months in the highest quartile [age > 80 years]), inappropriate empirical antibiotic treatment (median survival, 4.9 months), nosocomial infection (median survival, 9.6 months), and malignancy (median survival, 2.4 months).
  
  
  CONCLUSIONS
  Bacteremia is associated with high short-term mortality, but also a sign of severely curtailed long-term prognosis, especially in patients with low functional capacity, low serum albumin, high serum creatinine, nosocomial infections, malignancy, inappropriate antimicrobial treatment, and septic shock and in elderly patients.
authors.affiliation: Department of Medicine B, Beilinson Medical Center, Petah Tiqva, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Leibovici
authors.forename: Z
authors.initials: Z
authors.lastname: Samra
authors.forename: H
authors.initials: H
authors.lastname: Konigsberger
authors.forename: M
authors.initials: M
authors.lastname: Drucker
authors.forename: S
authors.initials: S
authors.lastname: Ashkenazi
authors.forename: S D
authors.initials: SD
authors.lastname: Pitlik
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016470:Bacteremia / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D016469:Fungemia / Q000401:mortality*; D006801:Humans; D007557:Israel; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D015999:Multivariate Analysis; D016019:Survival Analysis; D017741:Survivors