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菌血症与长期过度死亡率相关:一项为期 12 年的基于人群的队列研究。

Bacteremia is associated with excess long-term mortality: a 12-year population-based cohort study.

机构信息

Department of Infectious Diseases, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.

Department of Emergency Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.

出版信息

J Infect. 2015 Feb;70(2):111-26. doi: 10.1016/j.jinf.2014.08.012. Epub 2014 Sep 9.

Abstract

OBJECTIVES

Little is known about long-term outcomes following bacteremia. We investigated long-term mortality and causes of death among bacteremia patients compared with population controls.

METHODS

Population-based cohort study of bacteremia patients and population controls matched on sex, year of birth, residency and calendar time, in Denmark during 2000-2008. We calculated absolute mortality and adjusted mortality rate ratios (MRRs) in predefined follow-up periods.

RESULTS

The absolute mortality for bacteremia patients (n = 7783) and population controls (n = 38,906) was 22.0% vs. 0.2% (30 days), 41.4% vs. 2.6% (1 year) and 75.8% vs. 36.6% (10 years). For bacteremia patients, the MRR was 115.3 (95% CI, 88.2-150.9) 0-30 days after bacteremia and 2.1 (95% CI, 1.8-2.3) from 5 years to end of follow-up. The most common causes of death were cancer and cardiovascular diseases. Within one year of bacteremia, the relative risk of death was highest for genitourinary diseases and infectious diseases. Among one-year survivors of bacteremia, the relative risk of death was increased for all major causes of death.

CONCLUSIONS

Bacteremia is associated with a poor prognosis and considerable excess long-term mortality compared with the general population. The most common causes of death after bacteremia are cancer and cardiovascular diseases.

SUMMARY

This population-based cohort study reports an excess long-term mortality among 7783 bacteremia patients compared with matched population controls during 12 years of follow-up. We identified patients in particular risk of death and reported novel information on causes of death.

摘要

目的

关于菌血症的长期预后知之甚少。我们研究了菌血症患者与人群对照相比的长期死亡率和死亡原因。

方法

这是一项基于人群的菌血症患者和人群对照的队列研究,在丹麦,研究对象为 2000 年至 2008 年期间匹配了性别、出生年份、居住地点和时间的菌血症患者和人群对照。我们在规定的随访期内计算了绝对死亡率和调整后的死亡率比值(MRR)。

结果

菌血症患者(n=7783)和人群对照(n=38906)的绝对死亡率分别为 22.0%和 0.2%(30 天)、41.4%和 2.6%(1 年)、75.8%和 36.6%(10 年)。菌血症患者的 MRR 在菌血症后 0-30 天为 115.3(95%CI,88.2-150.9),5 年至随访结束时为 2.1(95%CI,1.8-2.3)。最常见的死亡原因是癌症和心血管疾病。在菌血症发生后的一年内,泌尿生殖系统疾病和传染病的死亡风险最高。在菌血症存活一年的患者中,所有主要死亡原因的死亡风险均增加。

结论

与普通人群相比,菌血症患者预后较差,长期死亡率明显较高。菌血症后最常见的死亡原因是癌症和心血管疾病。

摘要

本基于人群的队列研究报告了 7783 例菌血症患者与 12 年随访期间的匹配人群对照相比,存在长期死亡率过高的情况。我们确定了处于高死亡风险的患者,并报告了有关死亡原因的新信息。

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