Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
BMC Infect Dis. 2021 Nov 26;21(1):1188. doi: 10.1186/s12879-021-06898-8.
The long-term outcome is currently a crucial issue in critical care, and we aim to address the association between culture positivity and long-term mortality in critically ill patients.
We used the 2015-2019 critical care database at Taichung Veterans General Hospital and Taiwanese nationwide death registration files. Multivariable Cox proportional hazards regression model was conducted to determine hazard ratio (HR) and 95% confidence interval (CI).
We enrolled 4488 critically ill patients, and the overall mortality was 55.2%. The follow-up duration among survivors was 2.2 ± 1.3 years. We found that 52.6% (2362/4488) of critically ill patients had at least one positive culture during the admission, and the number of patients with positive culture in the blood, respiratory tract and urinary tract were 593, 1831 and 831, respectively. We identified that a positive culture from blood (aHR 1.233; 95% CI 1.104-1.378), respiratory tract (aHR 1.217; 95% CI 1.109-1.364) and urinary tract (aHR 1.230; 95% CI 1.109-1.364) correlated with an increased risk of long-term mortality after adjusting relevant covariates.
Through linking two databases, we found that positive culture in the blood, respiratory tract and urinary tract during admission correlated with increased long-term overall mortality in critically ill patients.
长期预后目前是重症监护的关键问题,本研究旨在探讨重症患者培养阳性与长期死亡率之间的关系。
我们使用了 2015-2019 年台中荣民总医院重症监护数据库和台湾全国死亡登记档案。采用多变量 Cox 比例风险回归模型确定风险比(HR)和 95%置信区间(CI)。
共纳入 4488 例重症患者,总体死亡率为 55.2%。幸存者的随访时间为 2.2±1.3 年。我们发现 52.6%(2362/4488)的重症患者在入院期间至少有一次培养阳性,血、呼吸道和尿路培养阳性的患者分别为 593、1831 和 831 例。我们发现血液(aHR 1.233;95% CI 1.104-1.378)、呼吸道(aHR 1.217;95% CI 1.109-1.364)和尿路(aHR 1.230;95% CI 1.109-1.364)培养阳性与调整相关协变量后的长期全因死亡率增加相关。
通过连接两个数据库,我们发现入院时血液、呼吸道和尿路培养阳性与重症患者长期总体死亡率增加相关。