Ricardo M La Hoz1, Terrence Liu2, Donglu Xie3, Beverley Adams-Huet4, DuWayne L Willett5, Robert W Haley6, David E Greenberg7. 1. Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: Ricardo.LaHoz@UTSouthwestern.edu. 2. University of Texas Southwestern Medical Center, Dallas, TX, USA. 3. Academic Information Systems - Information Resources, University of Texas Southwestern Medical Center, Dallas, TX, USA. 4. Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX, USA. 5. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 6. Division of Epidemiology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 7. Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abstract
BACKGROUND: We created an electronic health record-based registry using automated data extraction tools to study the epidemiology of bloodstream infections (BSI) in solid organ transplant recipients. The overarching goal was to determine the usefulness of an electronic health record-based registry using data extraction tools for clinical research in solid organ transplantation. METHODS: We performed a retrospective single-center cohort study of adult solid organ transplant recipients from 2010 to 2015. Extraction tools were used to retrieve data from the electronic health record, which was integrated with national data sources. Electronic health records of subjects with positive blood cultures were manually adjudicated using consensus definitions. One-year cumulative incidence, risk factors for BSI acquisition, and 1-year mortality were analyzed by Kaplan-Meier method and Cox modeling, and 30-day mortality with logistic regression. RESULTS: In 917 solid organ transplant recipients the cumulative incidence of BSI was 8.4% (95% confidence interval 6.8-10.4) with central line-associated BSI as the most common source. The proportion of multidrug-resistant isolates increased from 0% in 2010 to 47% in 2015 (p = 0.03). BSI was the strongest risk factor for 1-year mortality (HR=8.44; 4.99-14.27; p<0.001). In 11 of 14 deaths, BSI was the main cause or contributory in patients with non-rapidly fatal underlying conditions. CONCLUSIONS: Our study illustrates the usefulness of an electronic health record-based registry using automated extraction tools for clinical research in the field of solid organ transplantation. A BSI reduces the 1-year survival of solid organ transplant recipients. The most common sources of BSIs in our studies are preventable.
BACKGROUND: We created an electronic health record-based registry using automated data extraction tools to study the epidemiology of bloodstream infections (BSI) in solid organ transplant recipients. The overarching goal was to determine the usefulness of an electronic health record-based registry using data extraction tools for clinical research in solid organ transplantation. METHODS: We performed a retrospective single-center cohort study of adult solid organ transplant recipients from 2010 to 2015. Extraction tools were used to retrieve data from the electronic health record, which was integrated with national data sources. Electronic health records of subjects with positive blood cultures were manually adjudicated using consensus definitions. One-year cumulative incidence, risk factors for BSI acquisition, and 1-year mortality were analyzed by Kaplan-Meier method and Cox modeling, and 30-day mortality with logistic regression. RESULTS: In 917 solid organ transplant recipients the cumulative incidence of BSI was 8.4% (95% confidence interval 6.8-10.4) with central line-associated BSI as the most common source. The proportion of multidrug-resistant isolates increased from 0% in 2010 to 47% in 2015 (p = 0.03). BSI was the strongest risk factor for 1-year mortality (HR=8.44; 4.99-14.27; p<0.001). In 11 of 14 deaths, BSI was the main cause or contributory in patients with non-rapidly fatal underlying conditions. CONCLUSIONS: Our study illustrates the usefulness of an electronic health record-based registry using automated extraction tools for clinical research in the field of solid organ transplantation. A BSI reduces the 1-year survival of solid organ transplant recipients. The most common sources of BSIs in our studies are preventable.
Authors: A-P Magiorakos; A Srinivasan; R B Carey; Y Carmeli; M E Falagas; C G Giske; S Harbarth; J F Hindler; G Kahlmeter; B Olsson-Liljequist; D L Paterson; L B Rice; J Stelling; M J Struelens; A Vatopoulos; J T Weber; D L Monnet Journal: Clin Microbiol Infect Date: 2011-07-27 Impact factor: 8.067
Authors: Dale W Bratzler; E Patchen Dellinger; Keith M Olsen; Trish M Perl; Paul G Auwaerter; Maureen K Bolon; Douglas N Fish; Lena M Napolitano; Robert G Sawyer; Douglas Slain; James P Steinberg; Robert A Weinstein Journal: Am J Health Syst Pharm Date: 2013-02-01 Impact factor: 2.637
Authors: Victor L Yu; Christine C C Chiou; Charles Feldman; Ake Ortqvist; Jordi Rello; Arthur J Morris; Larry M Baddour; Carlos M Luna; David R Snydman; Margaret Ip; Wen Chien Ko; M Bernadete F Chedid; Antoine Andremont; Keith P Klugman Journal: Clin Infect Dis Date: 2003-07-07 Impact factor: 9.079
Authors: Yi Kee Poon; Ricardo M La Hoz; Linda S Hynan; James Sanders; Marguerite L Monogue Journal: Open Forum Infect Dis Date: 2021-03-06 Impact factor: 3.835
Authors: Ricardo M La Hoz; Ashley Wallace; Nicolas Barros; Donglu Xie; Linda S Hynan; Terrence Liu; Christina Yek; Scott Schexnayder; Justin L Grodin; Sonia Garg; Mark H Drazner; Matthias Peltz; Robert W Haley; David E Greenberg Journal: Transpl Infect Dis Date: 2020-12-09