title: The impact of previous hospitalization in the preceding 90 days on the outcome in critically ill patients with gram-negative bloodstream infection.
abstract: We conducted a retrospective cohort study to evaluate the impact of previous hospitalization in the preceding 90 days on mortality in critically ill patients with gram-negative bloodstream infection (BSI) and to identify the risk factors for 30-day mortality in these patients. Of 89 critically ill patients with gram-negative BSI, 42 patients had previous hospitalization in the preceding 90 days. Multivariate Cox regression analysis revealed previous hospitalization in the preceding 90 days as a significant predictor for 30-day mortality (hazard ratio [HR], 2.10; 95% confidence interval [CI], 1.11-3.94; P = 0.022), along with Acute Physiology and Chronic Health Evaluation II score at BSI onset (HR, 1.08; 95% CI, 1.04-1.12; P < 0.001), liver cirrhosis (HR, 3.61; 95% CI, 1.46-8.94; P = 0.006), and inappropriate definitive antimicrobial therapy (HR, 4.28; 95% CI, 2.17-8.45; P < 0.001). The effect of previous hospitalization in the preceding 90 days should be considered in evaluating the risk for 30-day mortality when treating such patients, and further study is required.
authors.affiliation: Department of Respiratory Medicine, Sun Yat-Sen Memorial hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Qiaojun
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: Department of Nosocomial infections management, Sun Yat-Sen Memorial hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Fengqin
authors.initials: F
authors.lastname: Xu
authors.affiliation: Department of Respiratory Medicine, Sun Yat-Sen Memorial hospital, Sun Yat-Sen University, Guangzhou, China; Institute of Antibiotics, Sun Yat-Sen Memorial hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: shanpingj_sys@126.com.
authors.forename: Shanping
authors.initials: S
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000401:mortality*; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Bloodstream infections; Gram-negative bacteria infections; Poor prognostic factors; Previous hospitalization; Septic shock; Severe sepsis