Impact of total body weight on 30-day mortality in patients with gram-negative bacteremia

ABSTRACT

Background: The impact of total body weight (TBW) on 30-day mortality associated with gram-negative bacteremia has not been previously evaluated.

Methods: The cohort included 323 patients >/ = 18 years old with gram-negative bacteremia (1/1/2008–8/31/2011) who received >/ = 48 hours of antibiotics. We compared 30-day mortality of TBW <70 kg vs. >/ = 70 kg with a multivariable stepwise logistic regression adjusting for age >/ = 70 years, cancer diagnosis, and Pitt bacteremia score of >/ = 4.

Results: The cohort was 57% TBW >/ = 70 kg and 43% TBW <70 kg. TBW >/ = 70 kg patients had lower 30-day mortality (11.0% vs. 16.3%), which was significant in the multivariable analysis (OR 0.45, 95% CI 0.21–0.97). Cancer and Pitt bacteremia score >/ = 4 were also independently associated with 30-day mortality. TBW was no longer significant when TBW <50 kg patients were excluded.

Conclusion: TBW >/ = 70 kg was associated with an improved 30-day mortality; however, the high mortality rates for patients with a TBW < 50 kg is responsible for this association.

KEYWORDS:

• Gram-negative
• total body weight
• bacteremia
• Escherichia coli
• Klebsiella sp

Declaration of interest

R.G. Hall has worked on the advisory board of Genentech and has received grant support from Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

C. Alvarez is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (K08 DK101602).