Candidaemia and a risk predictive model for overall mortality: a prospective multicentre study

Autor: K. McDonald, Karina Kennedy, Tania C. Sorrell, H. L. Wilson, S. C-A. Chen, Narin Bak, Sarah E. Kidd, Monica A. Slavin, Alun Pope, Krispin Hajkowicz, Deborah Marriott, Neil Underwood, Belinda Chapman, Caitlin Keighley, Catriona Halliday, Quoc Nguyen, S. J. van Hal, Jai N Darvall
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
Multivariate analysis
Antifungal Agents
030106 microbiology
Malignancy
law.invention
lcsh:Infectious and parasitic diseases
03 medical and health sciences
0302 clinical medicine
Candidaemia
Invasive fungal infection
law
Predictive Value of Tests
Risk Factors
Internal medicine
Epidemiology
medicine
Humans
lcsh:RC109-216
030212 general & internal medicine
Prospective Studies
Mortality
Prospective cohort study
Aged
Candida
Receiver operating characteristic
business.industry
Candida blood stream infection
Organ dysfunction
Australia
Candidemia
Middle Aged
medicine.disease
Intensive care unit
Risk stratification score
Hospitalization
Intensive Care Units
Infectious Diseases
ROC Curve
Predictive value of tests
Hematologic Neoplasms
Multivariate Analysis
Female
medicine.symptom
business
Research Article
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-10 (2019)
ISSN: 1471-2334
Popis: Background Candidaemia is associated with high mortality. Variables associated with mortality have been published previously, but not developed into a risk predictive model for mortality. We sought to describe the current epidemiology of candidaemia in Australia, analyse predictors of 30-day all-cause mortality, and develop and validate a mortality risk predictive model. Methods Adults with candidaemia were studied prospectively over 12 months at eight institutions. Clinical and laboratory variables at time of blood culture-positivity were subject to multivariate analysis for association with 30-day all-cause mortality. A predictive score for mortality was examined by area under receiver operator characteristic curves and a historical data set was used for validation. Results The median age of 133 patients with candidaemia was 62 years; 76 (57%) were male and 57 (43%) were female. Co-morbidities included underlying haematologic malignancy (n = 20; 15%), and solid organ malignancy in (n = 25; 19%); 55 (41%) were in an intensive care unit (ICU). Non-albicans Candida spp. accounted for 61% of cases (81/133). All-cause 30-day mortality was 31%. A gastrointestinal or unknown source was associated with higher overall mortality than an intravascular or urologic source (p 65 years, ICU admission, chronic organ dysfunction, preceding surgery within 30 days, haematological malignancy, source of candidaemia and antibiotic therapy for ≥10 days stratified patients into
Databáze: OpenAIRE
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