Bacteremia is associated with excess long-term mortality: a 12-year population-based cohort study

Abstract

Objectives: Little is known about long-term outcomes following bacteremia. We investigated long-term mortality and causes of death among bacteremia patients compared with population controls.

Methods: Population-based cohort study of bacteremia patients and population controls matched on sex, year of birth, residency and calendar time, in Denmark during 2000-2008. We calculated absolute mortality and adjusted mortality rate ratios (MRRs) in predefined follow-up periods.

Results: The absolute mortality for bacteremia patients (n = 7783) and population controls (n = 38,906) was 22.0% vs. 0.2% (30 days), 41.4% vs. 2.6% (1 year) and 75.8% vs. 36.6% (10 years). For bacteremia patients, the MRR was 115.3 (95% CI, 88.2-150.9) 0-30 days after bacteremia and 2.1 (95% CI, 1.8-2.3) from 5 years to end of follow-up. The most common causes of death were cancer and cardiovascular diseases. Within one year of bacteremia, the relative risk of death was highest for genitourinary diseases and infectious diseases. Among one-year survivors of bacteremia, the relative risk of death was increased for all major causes of death.

Conclusions: Bacteremia is associated with a poor prognosis and considerable excess long-term mortality compared with the general population. The most common causes of death after bacteremia are cancer and cardiovascular diseases.

Summary: This population-based cohort study reports an excess long-term mortality among 7783 bacteremia patients compared with matched population controls during 12 years of follow-up. We identified patients in particular risk of death and reported novel information on causes of death.

Keywords: Bacteremia; Causes of death; Epidemiology; Mortality; Population-based.