Bryan C S, Hornung C A, Reynolds K L, Brenner E R
Am J Epidemiol. 1986 Jan;123(1):113-27. doi: 10.1093/oxfordjournals.aje.a114205.
Between 1977 and 1981, there were 4.9 episodes of community-acquired bacteremia and 5.1 episodes of hospital-acquired bacteremia per 1,000 patients in the four major hospitals of one metropolitan area. Case fatality rates were 30.1 per cent based on deaths due to all causes and 14.7 per cent based on deaths attributed specifically to bacteremia. Patients who experienced bacteremia had a 12-fold excess in mortality compared with other patients. Bacteremia occurred more frequently and was associated with greater case fatality rates at university-affiliated teaching hospitals compared with nonteaching community hospitals. At the nonteaching community hospitals, the odds of mortality for patients with bacteremia were lower even after adjustment for age, sex, severity of underlying medical problems, and severity of infection. Patients on private services at a teaching municipal hospital experienced greater odds of mortality compared with private patients at two nonteaching community hospitals. These latter observations may reflect, at least in part, limitations in the standard parameters used for determining severity of underlying medical problems and severity of infection.
1977年至1981年期间，在一个大都市地区的四家主要医院中，每1000名患者中有4.9例社区获得性菌血症发作和5.1例医院获得性菌血症发作。基于所有原因导致的死亡，病死率为30.1%；基于明确归因于菌血症的死亡，病死率为14.7%。发生菌血症的患者死亡率比其他患者高出12倍。与非教学社区医院相比，大学附属医院的菌血症发生率更高，且病死率更高。在非教学社区医院，即使对年龄、性别、基础疾病严重程度和感染严重程度进行调整后，菌血症患者的死亡几率仍然较低。与两家非教学社区医院的私立患者相比，教学市立医院私立病房的患者死亡几率更高。后一种观察结果可能至少部分反映了用于确定基础疾病严重程度和感染严重程度的标准参数存在局限性。
