Chronic heart failure and mortality in patients with community-acquired Staphylococcus aureus bacteremia: a population-based cohort study

BMC Infectious Diseases

Research Article

Mette Søgaard¹  Reimar Wernich Thomsen¹  Kasper Adelborg²  Henrik Carl Schønheyder³  Jesper Smit⁴ 

[1] Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK-8200, Aarhus, Denmark;Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK-8200, Aarhus, Denmark;Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Denmark;Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, DK-9000, Aalborg, Denmark;Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, DK-9000, Aalborg, Denmark;Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, DK-9000, Aalborg, Denmark;Department of Infectious Diseases, Aalborg University Hospital, P.O. Box 365, Mølleparkvej 4, DK-9100, Aalborg, Denmark;Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK-8200, Aarhus, Denmark;

关键词: Congestive heart failure;    Staphylococcus aureus;    Bacteremia;    Mortality;    Prognosis;   

DOI  :  10.1186/s12879-016-1570-7

 received in 2015-11-24, accepted in 2016-05-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPatients with chronic heart failure (CHF) may experience higher mortality of Staphylococcus aureus bacteremia (SAB) than patients without CHF due to insufficient cardiovascular responses during systemic infection. We investigated 90-day mortality in SAB patients with and without CHF.MethodsUsing population-based medical databases, we conducted a cohort study of all adult patients with community-acquired SAB (CA-SAB) in Northern Denmark, 2000-2011. Ninety-day mortality after SAB for patients with and without CHF was estimated by the Kaplan-Meier method. Based on Cox regression analysis, we computed hazard ratios as estimates of mortality rate ratios (MRRs) overall and stratified by CHF-related conditions (e.g., cardiomyopathy and valvular heart disease), CHF severity (defined by daily dosage of loop-diuretics), and CHF duration while adjusting for potential confounders.ResultsAmong 2638 SAB patients, 390 (14.8 %) had a history of CHF. Ninety-day mortality was 45 % in patients with CHF and 30 % in patients without CHF, which yielded an adjusted MRR (aMRR) of 1.24 (95 % CI, 1.04-1.48). Compared to patients without CHF, the excess risk of death was most pronounced among patients with valvular heart disease (aMRR = 1.73 (95 % CI, 1.26–2.38)), patients with daily loop-diuretic dosages of 81–159 mg/day (aMRR = 1.55 (95 % CI, 1.11–2.14)) and ≥160 mg/day (aMRR = 1.62 (95 % CI, 1.21–2.18)), and among patients with <3 years of CHF duration (aMRR = 1.43 (95 % CI, 1.14–1.78)).ConclusionCA-SAB patients with CHF experienced increased 90-day mortality compared to patients without CHF.

【 授权许可】

CC BY   
© The Author(s). 2016