Risk Factors For Mortality In Patients With Anaero

Authors: J R Wilson A P Limaye

Publish Date: 2004/03/13

Volume: 23, Issue: 4, Pages: 310-316

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Abstract

Risk factors for mortality in anaerobic bacteremia have been incompletely defined The aims of the present study were to determine clinical significance by pathogen for a broad range of obligate anaerobic organisms isolated from blood and to define the factors independently associated with mortality among those with clinically significant bacteremia All patients who had anaerobic bacteria isolated from blood over a 19month period from 1 September 1998 to 1 April 2000 at two urban teaching hospitals were included in this study Each case was analyzed for clinical significance by means of a retrospective medical record review using predetermined definitions Information was collected on a broad range of clinical and microbiological factors which were evaluated for their association with mortality using a Cox proportional hazards model Among 166 patients with obligate anaerobic bacteria isolated from blood 73 44 were deemed to have clinically significant bacteremia Clinical significance ranged from 0 0/53 for Propionibacterium spp to 96 43/45 for Bacteroides spp The crude mortality rate in patients with clinically significant anaerobic bacteremia was 25 18/73 Mortality was significantly associated with age polymicrobial infection and underlying heart kidney or liver disease in univariate analysis Only the presence of liver disease relative risk 53 95 confidence interval 17–160 P=0003 and patient age relative risk 106/y 95 confidence interval 10–11 P=0005 remained significant in multivariate analysis Among patients with anaerobic bacteremia clinical significance varies markedly by pathogen and mortality is independently associated with age and underlying liver diseaseThe authors thank Dr A Dewanji of the Indian Statistical Institute Calcutta India and Dr S Moolgavkar of the Fred Hutchinson Cancer Research Center Seattle Washington USA for their generous help with statistical analysis Dr S Pottumarthy of the University of Washington Seattle Washington USA for her critical review of the manuscript and E Stefansson of the University of Washington Seattle Washington USA for his assistance with data collection This study was reviewed and accepted by our institution’s Independent Review Board and complies with all applicable United States laws governing research

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