title: Risk factors for mortality among patients with Staphylococcus aureus bacteremia: a single-centre retrospective cohort study.
abstract: BACKGROUND
  Staphylococcus aureus bacteremia is associated with significant morbidity and mortality. Given the paucity of recent Canadian data, we estimated the mortality rate associated with S. aureus bacteremia in a tertiary care hospital and identified risk factors associated with mortality.
  
  
  METHODS
  We retrospectively reviewed the records of adults with S. aureus bacteremia admitted to a tertiary care centre in southwestern Ontario between 2008 and 2012. Cox regression analysis was used to evaluate associations between predictor variables and all-cause, in-hospital, and 90-day postdischarge mortality.
  
  
  RESULTS
  Of the 925 patients involved in the study, 196 (21.2%) died in hospital and 62 (6.7%) died within 90 days after discharge. Risk factors associated with in-hospital and all-cause mortality included age, sepsis (adjusted hazard ratio [adjusted HR] 1.49, 95% confidence interval [CI] 1.08-2.06, p = 0.02), admission to the intensive care unit (adjusted HR 3.78, 95% CI 2.85-5.02, p < 0.0001), hepatic failure (adjusted HR 3.36, 95% CI 1.91-5.90, p < 0.0001) and metastatic cancer (adjusted HR 2.58, 95% CI 1.77-3.75, p < 0.0001). Methicillin resistance, hepatic failure, cerebrovascular disease, chronic obstructive pulmonary disease and metastatic cancer were associated with postdischarge mortality.
  
  
  CONCLUSIONS
  The all-cause mortality rate in our cohort was 27.9%. Identification of predictors of mortality may guide empiric therapy and provide prognostic clarity for patients with S. aureus bacteremia.
authors.affiliation: Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. ; Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Ram Venkatesh
authors.initials: RV
authors.lastname: Anantha
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Januvi
authors.initials: J
authors.lastname: Jegatheswaran
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Daniel Luke
authors.initials: DL
authors.lastname: Pepe
authors.affiliation: Division of Critical Care Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Fran
authors.initials: F
authors.lastname: Priestap
authors.affiliation: Department of Pathology, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Johan
authors.initials: J
authors.lastname: Delport
authors.affiliation: Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: S M Mansour
authors.initials: SM
authors.lastname: Haeryfar
authors.affiliation: Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: John K
authors.initials: JK
authors.lastname: McCormick
authors.affiliation: Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. ; Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, Ont. ; Division of Critical Care Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Tina
authors.initials: T
authors.lastname: Mele