Impact of bloodstream infection on outcomes among infected surgical inpatients.
OBJECTIVE
To assess the importance of bloodstream infection (BSI) to outcomes among infected surgical patients.


BACKGROUND
Bloodstream infection complicating infection is thought to connote a more serious condition compared with a primary infection alone. The authors recently reported, however, that BSI does not alter outcomes with central venous catheter colonization in the presence of sepsis. The significance of BSI with other infections has been incompletely evaluated.


METHODS
Data on all episodes of infection among surgical patients were collected prospectively during a 38-month period at a single hospital, then analyzed retrospectively to determine the independent prognostic value of BSI for all infections by logistic regression analysis, and for abdominal infections and pneumonia using matched control groups.


RESULTS
During the study period, 2,076 episodes of infection occurred, including 363 with BSI. Patients with BSI had a greater severity of illness and a greater death rate. After logistic regression, however, BSI did not independently predict death. After matching patients with abdominal infections and pneumonia with BSI to patients without BSI but with a similar site of infection, severity of illness, age, and causative organism, no difference in outcome was seen.


CONCLUSIONS
Bloodstream infection is associated with critical illness and death but appears to be a marker of severe primary disease rather than an independent predictor of outcome.
Raymond
D P
DP
Surgical Infectious Disease Laboratory, Department of Surgery, University of Virginia Medical School, Charlottesville, Virginia, USA. dpr4w@virginia.edu
Pelletier
S J
SJ
Crabtree
T D
TD
Gleason
T G
TG
Pruett
T L
TL
Sawyer
R G
RG
D018806:APACHE; D016470:Bacteremia / Q000453:epidemiology*; D016022:Case-Control Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018410:Pneumonia, Bacterial / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative