Shah Shahin, Nadeem Muhammad D, Ali Junaid, Ahmad Umair, Mahmood Abroo, Ikhlas Zainab
General Medicine, Medlife Medical Center, Abu Dhabi, ARE.
Medicine, Khyber Medical University, Peshawar, PAK.
Cureus. 2024 Jul 24;16(7):e65275. doi: 10.7759/cureus.65275. eCollection 2024 Jul.
Background The objective of our investigation was to evaluate the mortality rate and predictor factors that are associated with bloodstream infections (BSIs) in elderly patients who are admitted to the internal medicine ward. Materials and methods A retrospective cross-sectional analysis was conducted at a 550-bed tertiary care hospital in Peshawar, Pakistan, from January 2021 to June 2022. The study involved elderly inpatients aged 65 and older with positive culture results detected within two days of admission. Data collection involved demographic and patient-related risk variables, BSI-related risk factors, and environmental risk factors, with statistical analysis performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY). Results Of the total study sample (n=186), 103 (55.4%) survived while 83 (44.6%) did not. The non-survivor group had a higher median Sequential Organ Failure Assessment (SOFA) score (6 vs. 2, p<0.0001) and Charlson Comorbidity Index (5 ± 2 vs. 3 ± 2, p<0.0001), with more frequent immunosuppression (25.3% vs. 8.7%, p=0.001). Additionally, gram-positive bacteria were more common in non-survivors (42% vs. 10%, p<0.0001), while gram-negative bacteria were more prevalent in survivors (73% vs. 36%, p=0.002). Conclusions Our research validates that BSI in older adults is a serious condition that is linked to a substantial death rate during hospitalization. The biggest determinant of death in older patients with BSI is the severity of clinical symptoms evaluated by the SOFA score upon admission. It is imperative to acknowledge that respiratory-induced BSIs are the most fatal, and patients who are hospitalized and admitted to the intensive care unit (ICU) are at an elevated risk.
背景 我们调查的目的是评估入住内科病房的老年患者血流感染(BSIs)的死亡率及相关预测因素。
材料与方法 2021年1月至2022年6月,在巴基斯坦白沙瓦一家拥有550张床位的三级医疗医院进行了一项回顾性横断面分析。该研究纳入了65岁及以上的老年住院患者,这些患者在入院两天内血培养结果呈阳性。数据收集涉及人口统计学和患者相关风险变量、BSI相关危险因素以及环境危险因素,并使用社会科学统计软件包(IBM SPSS Statistics for Windows,IBM公司,版本26.0,纽约州阿蒙克)进行统计分析。
结果 在整个研究样本(n = 186)中,103例(55.4%)存活,83例(44.6%)死亡。非存活组的序贯器官衰竭评估(SOFA)评分中位数较高(6比2,p < 0.xxx1),查尔森合并症指数也较高(5 ± 2比3 ± 2,p < 0.xxx1),免疫抑制情况更常见(25.3%比8.7%,p = 0.001)。此外,革兰氏阳性菌在非存活者中更常见(42%比10%,p < 0.xxx1),而革兰氏阴性菌在存活者中更普遍(73%比36%,p = 0.002)。
结论 我们的研究证实,老年人的BSI是一种严重疾病,与住院期间的高死亡率相关。老年BSI患者死亡的最大决定因素是入院时通过SOFA评分评估的临床症状严重程度。必须认识到,呼吸道引起的BSI最为致命,住院并入住重症监护病房(ICU)的患者风险更高。