title: Attributable mortality of nosocomial candidemia, revisited.
abstract: We reexamined the attributable mortality of nosocomial candidemia 15 years after a retrospective cohort study performed at our hospital demonstrated an attributable mortality of 38%. For all episodes of nosocomial candidemia between 1 July 1997 and 30 June 2001, we matched control patients with case patients by age, sex, date of hospital admission, underlying disease(s), length of time at risk, and surgical procedure(s). We analyzed 108 matched pairs. There were no statistically significant differences in age, sex, underlying disease(s), time at risk, surgical procedure, or vital signs at admission between cases and controls. The crude mortality among case patients was 61% (66 of 108 patients), compared with 12% (13 of 108) among control patients, for an attributable mortality of 49% (95% CI, 38%-60%). Nosocomial candidemia is still associated with an extremely high crude and attributable mortality--much higher than that expected from underlying disease alone.
authors.affiliation: Department of Epidemiology, University of Iowa College of Public Health, Iowa City, USA.
authors.forename: Olafur
authors.initials: O
authors.lastname: Gudlaugsson
authors.forename: Shane
authors.initials: S
authors.lastname: Gillespie
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lee
authors.forename: Jeff
authors.initials: J
authors.lastname: Vande Berg
authors.forename: Jianfang
authors.initials: J
authors.lastname: Hu
authors.forename: Shawn
authors.initials: S
authors.lastname: Messer
authors.forename: Loreen
authors.initials: L
authors.lastname: Herwaldt
authors.forename: Michael
authors.initials: M
authors.lastname: Pfaller
authors.forename: Daniel
authors.initials: D
authors.lastname: Diekema
mesh_terms: D000367:Age Factors; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification / Q000187:drug effects; D002177:Candidiasis / Q000401:mortality*; D015331:Cohort Studies; D003428:Cross Infection / Q000401:mortality*; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D016469:Fungemia / Q000401:mortality*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole