title: Liver cirrhosis as a risk factor for mortality in a national cohort of patients with bacteremia.
abstract: OBJECTIVE
  The purpose of this study was to evaluate clinical features and outcomes of bacteremia in patients with liver cirrhosis (LC) and determine whether underlying LC is an independent risk factor for mortality in a population of patients with different underlying diseases.
  
  
  METHODS
  From the database of nationwide surveillance studies for bacteremia, data regarding bacteremia in patients with LC were analyzed and compared with those in patients with other diseases.
  
  
  RESULTS
  A total of 195 patients with LC were compared with 1659 patients with other underlying diseases. As for the site of infection, intraabdominal infection was more frequent in the LC group (P < 0.001), while pneumonia, urinary tract bacteremia, and primary bacteremia were more prevalent in the other diseases group (all P < 0.05). Patients with LC were more likely to have Klebsiella pneumoniae bacteremia (20.1% vs. 14.3%, P = 0.018), but less likely to have coagulase-negative staphylococcal bacteremia (5.1% vs. 10.4%, P = 0.028). The 30-day mortality rate was significantly higher in the LC group compared to the other disease group (27.2% [53/195] vs. 20.3% [336/1659], P = 0.025). Multivariate analysis revealed underlying LC as a significant predictor for mortality (OR, 2.11; 95% CI, 1.43-3.13; P < 0.001), along with old age, nosocomial acquisition, pneumonia, severe sepsis, and a higher Pitt bacteremia score.
  
  
  CONCLUSIONS
  The mortality rate of patients with LC was significantly higher than that of patients with other diseases when they developed bacteremia. Underlying LC was found to be one of the independent risk factors for mortality in patients with bacteremia.
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
authors.forename: Doo Ryeon
authors.initials: DR
authors.lastname: Chung
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Joon-Sup
authors.initials: JS
authors.lastname: Yeom
authors.forename: Hyun Kyun
authors.initials: HK
authors.lastname: Ki
authors.forename: Jun Seong
authors.initials: JS
authors.lastname: Son
authors.forename: Jin Seo
authors.initials: JS
authors.lastname: Lee
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.forename: Shin-Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Hyun-Ha
authors.initials: HH
authors.lastname: Chang
authors.forename: Seong Yeol
authors.initials: SY
authors.lastname: Ryu
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kwon
authors.forename: Hyuck
authors.initials: H
authors.lastname: Lee
authors.forename: Dong Sik
authors.initials: DS
authors.lastname: Jung
authors.forename: Chisook
authors.initials: C
authors.lastname: Moon
authors.forename: Sang Taek
authors.initials: ST
authors.lastname: Heo
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Rhee
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D016022:Case-Control Studies; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D016896:Treatment Outcome