https://orcid.org/0000-0002-3667-4918
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Abstract
Introduction
Elderly patients with immunosuppressive status may have increased risk of mortality. At present, few studies have explored the clinical characteristics of the elderly immunosuppressed population with bloodstream infection. Our objectives were to evaluate the prognostic factors in immunosuppressed elderly patients with bloodstream infection.
Methods
Three hundred and seventy-six elderly patients who were diagnosed with bloodstream infection in immunosuppressive status while receiving treatment in our hospital were selected from 2015 to 2019. The demographic data, underlying diseases, comorbidity, inducement, complications, pathogen sources, etiologies and the antibiotic therapy were analyzed between 90-day survival groups and 90-day mortality groups. The prognostic factors of 90-day mortality were evaluated by univariate logistic regression analysis and multivariate logistic regression analysis.
Results
The clinical characteristics of 376 immunosuppressed elderly people diagnosed with bloodstream infection were analyzed, and among those people about 111 were 90-day mortality. By univariate logistic regression analysis and multivariate logistic regression analysis, we found ICU admission (OR: 2.052, 95%CI: 1.088–3.871, p=0.026), the decrease in BMI (OR: 0.307, 95%CI: 0.130–0.723, p=0.007), coronary heart disease (OR: 2.028, 95%CI: 1.078–3.816, p=0.028), biliary infection (OR: 4.406, 95%CI: 1.794–10.821, p=0.001) and the use of tigecycline (OR: 2.480, 95%CI: 1.195–5.147, p=0.015) were significantly different between the 90-day survival and 90-day mortality groups.
Conclusion
ICU admission, coronary heart disease, biliary infection, and the use of tigecycline were the independent prognostic risk factors of 90-day mortality in immunosuppressed elderly people, and the decrease in BMI was the protective factor, which would have the benefit of discriminating the prognostic factors in immunosuppressed elderly people with bloodstream infection.
Abbreviations
BMI, body mass index; PCT, procalcitonin; ICU, intensive care unit; BSI, bloodstream infection; COVID-19, coronavirus disease 2019; ECMO, extracorporeal membrane oxygenation.
Data Sharing Statement
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
Compliance with Ethics Guideline
Our research was based on previous clinical data and other personal information like the patient’s name, phone number, address were not involved. The patient informed consent exemption was approved and the ethical clearance had been acquired from the Medicine Ethics committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School. We claim that we cover patient data confidentially and compliance with the Declaration of Helsinki.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.