title: Functional status and quality of life after community-acquired bacteraemia: a matched cohort study.
abstract: Severe bacterial infections may have a prolonged negative effect on subsequent functional status and health-related quality of life. We studied hospitalized patients for changes in functional status and quality of life within 1 year of community-acquired bacteraemia in comparison to blood-culture-negative controls. In a prospectively conducted matched cohort study at Aalborg University Hospital, north Denmark, during 2011-2014, we included 71 medical inpatients with first-time community-acquired bacteraemia. For each bacteraemia patient, we matched one blood-culture-negative inpatient control on age and gender. Functional status and quality of life before and after hospitalization were assessed by Barthel-20 and EuroQol-5D questionnaires. We computed the 3-month and 1-year risk for any deterioration in Barthel-20 score and EuroQol-5D index score, and for a deterioration of ≥10 points in EuroQol-5D visual analogue scale score, and used regression analyses to assess adjusted risk ratios (RR) with 95% CIs. Compared with controls, bacteraemia was associated with an increased 3-month risk for deterioration in functional status as assessed by Barthel-20 score (14% versus 3% with deterioration, adjusted RR 5.1; 95% CI 1.2-22.3). The difference was less after 1 year (11% versus 7% with deterioration, adjusted RR 1.6; 95% CI 0.5-4.5). After 3 months, quality of life had become worse in 37% of bacteraemia patients and 28% of controls by EuroQol-5D index score (adjusted RR 1.3; 95% CI 0.8-2.1), with similar findings after 1 year and by visual analogue scale. In conclusion, community-acquired bacteraemia is associated with increased risk for subsequent deterioration in functional status compared with blood-culture-negative controls, and with a high risk for deterioration in quality of life.
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address: midp@rn.dk.
authors.forename: M
authors.initials: M
authors.lastname: Dalager-Pedersen
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: R W
authors.initials: RW
authors.lastname: Thomsen
authors.affiliation: Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: H C
authors.initials: HC
authors.lastname: Schønheyder
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Nielsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications*; D017714:Community-Acquired Infections / Q000150:complications*; D003718:Denmark; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Activities of daily living; functional status; infection; quality of life; sepsis