Laupland Kevin B, Pasquill Kelsey, Parfitt Elizabeth C, Dagasso Gabrielle, Gupta Kaveri, Steele Lisa
Department of Medicine, Royal Inland Hospital, Kamloops, BC, Canada,
Department of Pathology and Laboratory Medicine, Royal Inland Hospital, Kamloops, BC, Canada.
Clin Epidemiol. 2019 Jan 4;11:47-52. doi: 10.2147/CLEP.S187381. eCollection 2019.
Inhospital death is commonly used as an outcome measure. However, it may be a biased measure of overall fatal outcome. The objective of this study was to evaluate inhospital death as a measure of all-cause 30-day case fatality in patients with bloodstream infection (BSI).
A population-based surveillance cohort study was conducted, and patients who died in hospital within 30 days (30-day inhospital death) were compared with those who died in any location by day 30 post BSI diagnosis (30-day all-cause case fatality).
A total of 1,773 residents had first incident episodes of BSI. Overall, 299 patients died for a 30-day all-cause case fatality rate of 16.9%. Most (1,587; 89.5%) of the patients were admitted to hospital, and ten (5.4%) of the 186 patients not admitted to hospital died. Of the 1,587 admitted patients, 242 died for a 30-day inhospital death rate of 15.2%. A further 47 patients admitted to hospital died after discharge but within 30 days of BSI diagnosis for a 30-day case fatality rate among admitted patients of 18.2%. Patients who died following discharge within 30 days were older and more likely to have dementia.
The use of inhospital death is a biased measure of true case fatality.
住院死亡通常被用作一种结局指标。然而，它可能是总体死亡结局的一种有偏差的指标。本研究的目的是评估住院死亡作为血流感染（BSI）患者全因30天病例死亡率的一种指标。
进行了一项基于人群的监测队列研究，将30天内死于医院的患者（30天住院死亡）与BSI诊断后30天内在任何地点死亡的患者（30天全因病例死亡率）进行比较。
共有1773名居民首次发生BSI。总体而言，299名患者死亡，30天全因病例死亡率为16.9%。大多数患者（1587名；89.5%）入院治疗，186名未入院治疗的患者中有10名（5.4%）死亡。在1587名入院患者中，242名死亡，30天住院死亡率为15.2%。另有47名入院患者在出院后但在BSI诊断后30天内死亡，入院患者的30天病例死亡率为18.2%。在30天内出院后死亡的患者年龄更大，更有可能患有痴呆症。
使用住院死亡作为真实病例死亡率的指标存在偏差。
