[Factors affecting the clinical course of bacteremia. Prospective study at a university hospital]

Abstract

Background: The aim of this study was to identify the risk factors mainly influencing the mortality of a series of bacteremic patients.

Methods: A prospective study of the clinically significant bacteremias detected in the Hospital Clínico Universitario in Malaga (Spain) over the period from June 1994 to May 1995 was performed. Univariate analysis of the results was carried out with the chi 2 test and multivariate analysis was undertaken by logistic regression (Stepwise backward).

Results: The incidence of bacteremia was of 19.5 cases/1,000 admissions and the mortality was of 21.9%. According to the univariate analysis, 11 variables were significantly associated with greater risk death: age > 60 years, stay in the intensive care unit, respiratory diseases as the main diagnosis, etiology by Pseudomonas aeruginosa, absence of fever, septic shock, presence of chronic renal insufficiency, cirrhosis or heart disease with underlying diseases, performance of invasive procedures prior to and hospital stay of less than 10 days. Logistic regression analysis determined the factors which mainly influenced in the prognosis of bacteremia: septic shock (p < 0.0001, odds ratio [OR]: 17.97), cardiovascular diseases (p = 0.004, OR: 9.86), AIDS (p = 0.03; OR: 1.02).

Conclusions: Although the prognosis of bacteremia is strongly influenced by determined conditions of the patient, it may be improved, overall through the control of possible hemodynamic complications of the patients and to a lesser extent by antibiotic treatment.