Arne Nørgaard Eskesen1, Margrethe Astrup Belle1, Anita Blomfeldt2,3. 1. a Department of Infectious Diseases , Medical Division, Akershus University Hospital , Lørenskog , Norway. 2. b Department of Microbiology and Infection Control , Akershus University Hospital , Lørenskog , Norway. 3. c Department of Clinical Molecular Biology (EpiGen) , Akershus University Hospital and University of Oslo , Lørenskog , Norway.
Abstract
OBJECTIVES: Staphylococcus aureus bacteraemia (SAB) is a common infection associated with significant short-term mortality. Little is known about long-term prognosis. The aim of this study was to determine one-year all-cause mortality and infection-related mortality and associated predictors. METHODS: Data from 303 consecutive patients with SAB were prospectively collected from March 2011 to February 2014. All patients were followed one year or until death. RESULTS: One-year all-cause- and infection-related mortality were 36.7% and 20.8%, respectively. For all-cause mortality, in multivariable logistic regression analysis, age 70-79 years (OR 3.9; 95% CI 1.7-9.1; p = .001), Charlson Comorbidity index ≥3 (OR 6.9; 95% CI 2.7-17.3; p < .001), healthcare-associated infection (OR 2.3; 95% CI 1.1-4.9; p = .03) and severe sepsis (OR 3.6; 95% CI 1.8-7.1; p < .001) were independent predictors of outcome. For infection-related mortality, the predictors were similar, except for healthcare-associated infection that lost significance. The vast majority (89%) of infection-related deaths occurred within 30 days. CONCLUSIONS: This study demonstrates additional significant all-cause mortality in patients with SAB beyond 30 days to one year, mainly driven by high age and comorbidity. As a result, SAB can be considered an indirect marker of high risk of death in these patients. Follow-up beyond 30 days does not add significant information with respect to infection-related mortality.
OBJECTIVES:Staphylococcus aureus bacteraemia (SAB) is a common infection associated with significant short-term mortality. Little is known about long-term prognosis. The aim of this study was to determine one-year all-cause mortality and infection-related mortality and associated predictors. METHODS: Data from 303 consecutive patients with SAB were prospectively collected from March 2011 to February 2014. All patients were followed one year or until death. RESULTS: One-year all-cause- and infection-related mortality were 36.7% and 20.8%, respectively. For all-cause mortality, in multivariable logistic regression analysis, age 70-79 years (OR 3.9; 95% CI 1.7-9.1; p = .001), Charlson Comorbidity index ≥3 (OR 6.9; 95% CI 2.7-17.3; p < .001), healthcare-associated infection (OR 2.3; 95% CI 1.1-4.9; p = .03) and severe sepsis (OR 3.6; 95% CI 1.8-7.1; p < .001) were independent predictors of outcome. For infection-related mortality, the predictors were similar, except for healthcare-associated infection that lost significance. The vast majority (89%) of infection-related deaths occurred within 30 days. CONCLUSIONS: This study demonstrates additional significant all-cause mortality in patients with SAB beyond 30 days to one year, mainly driven by high age and comorbidity. As a result, SAB can be considered an indirect marker of high risk of death in these patients. Follow-up beyond 30 days does not add significant information with respect to infection-related mortality.
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