Effect of bloodstream infection on survival in COVID-19 patients admitted to an intensive care unit in Colombia: a matched cohort analysis.

Autor: Cortes JA; Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Facultad de Medicina, Bogotá, Colombia.; Infectious Diseases Service, Hospital Universitario Nacional, Bogotá, Colombia., Valderrama-Rios MC; Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Facultad de Medicina, Bogotá, Colombia., Nocua-Báez LC; Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Facultad de Medicina, Bogotá, Colombia.; Infectious Diseases Service, Hospital Universitario Nacional, Bogotá, Colombia., Quitián LM; Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Facultad de Medicina, Bogotá, Colombia., Lozada FA; Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Facultad de Medicina, Bogotá, Colombia., Buitrago G; Research Institute, Universidad Nacional de Colombia, Sede Bogotá, Facultad de Medicina, Bogotá, Colombia.
Jazyk: angličtina
Zdroj: Infection prevention in practice [Infect Prev Pract] 2023 Apr 29; Vol. 5 (2), pp. 100283. Date of Electronic Publication: 2023 Apr 29 (Print Publication: 2023).
DOI: 10.1016/j.infpip.2023.100283
Abstrakt: Aim: To determine the impact of bloodstream infection (BSI) and other risk factors for mortality in patients with COVID-19 admitted to the intensive care unit (ICU).
Methods: A retrospective cohort was carried out at the Hospital Universitario Nacional (HUN) between March 29 and December 19, 2020. Patients with COVID-19 admitted to the Intensive Care Unit (ICU) were paired 1:4 in two groups, one with BSI and the other without, according to hospital stay and the month of admission. The primary outcome was mortality at 28 days. A Cox proportional hazards model was used to estimate differences in mortality risk.
Results: 456 patients were identified and 320 were included in the final cohort, 18% (n = 59) in the BSI group and 82% (n = 261) in the control group. 125 (39%) patients died, 30 (51%) in the BSI group and 95 (36%) in the control group ( P  = 0.040). BSI was associated with an increased risk of in-hospital mortality at 28 days, [HR] 1.77 (95% CI: 1.03-3.02; P  = 0.037). Invasive mechanical ventilation (IMV) and age were associated with increased mortality risk. Some months of the year of the hospital stay were associated with a reduced risk of mortality. There was no difference in mortality between inappropriate and appropriate empirical antimicrobial use.
Conclusion: BSI in patients with COVID-19 in ICU increases in-hospital mortality to 28 days. Other risk factors for mortality were IMV and age.
(© 2023 The Authors.)
Databáze: MEDLINE
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