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Nosocomial bacteremia in very old patients: predictors of mortality

Gavazzi, Gaëtan ; Escobar, Philippe ; Olive, Frédéric ; Couturier, Pascal ; Franco, Alain

In: Aging Clinical and Experimental Research, 2005, vol. 17, no. 4, p. 337-342

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    Titel
    • Nosocomial bacteremia in very old patients: predictors of mortality
    Autor
    • Gavazzi, Gaëtan. Biology of Aging Laboratory, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Biology of Aging Laboratory, 2 chemin du Petit Bel-Air, 1225, Geneva, Switzerland
    • Escobar, Philippe. Geriatric Department, University Hospital of Grenoble, France
    • Olive, Frédéric. Department of Medical Informatics, University Hospital of Grenoble, France
    • Couturier, Pascal. Geriatric Department, University Hospital of Grenoble, France
    • Franco, Alain. Geriatric Department, University Hospital of Grenoble, France
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Aging Clinical and Experimental Research, 2005, vol. 17, no. 4, p. 337-342. Springer International Publishing
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:321815
    Summary
    Background and aims: Nosocomial Bacteremia (NB) is associated with high mortality in elderly patients. To determine specific prognostic factors for 7- and 30-day mortality in elderly patients with NB, we analysed the characteristics of 62 NB patients, retrospectively. Methods: This retrospective study concerns 62 cases of NB diagnosed within a 3-year period in a geriatric department. Bacteremia is described according to CDC definitions. Epidemiological characteristics, co-morbidities, clinical (activities of daily living (ADL) before NB) and biological findings (neutrophil count, lymphocyte count, albuminemia before NB) were collected for each patient. A systemic clinical reaction was defined by the presence of one of the following parameters: chills, hypothermia <36°C or hyperthermia >38.5°C, or shock. Types of micro-organism and source of NB were also collected. All variables were analysed for mortality at day 7 (7-day mortality) and at day 30 (30-day mortality). Results: The 7-day mortality rate was 21% and the 30-day rate was 45%. In multivariate analysis, 7-day mortality was only associated with the absence of systemic clinical reaction [OR 9.7 (3.7-25.7)]. Again, in multivariate analysis, 30-day mortality was associated with an ADL score <2 [OR 8.3 (4.3-16.4)] and cocci gram positive NB [OR= 3.6 (1.9-6.9)]. Conclusions: The absence of any systemic clinical reaction as a single independent predictor for 7-day mortality suggests either a poorer immune response to nosocomial bacteremia or a delay in diagnosis. Functional status was the strongest predictor for 30-day mortality. In this population, further prospective studies need to include these factors to evaluate predictors of mortality for serious infectious diseases