AI Article Synopsis
- A study aimed to identify risk factors for functional decline in patients after hospitalization for Gram-negative bacteremia, analyzing data from a cohort of 509 patients aged 71 on average, conducted between 2013 and 2017 in Israel and Italy.
- The researchers found that 24.4% of patients experienced functional decline within 90 days post-discharge, with specific risk factors including older age, preexisting functional dependence, certain comorbidities like cancer and chronic pulmonary disease, and longer hospital stays.
- Importantly, receiving appropriate antibiotic treatment was linked to significantly lower rates of functional decline, highlighting the need for effective healthcare strategies to improve long-term outcomes for these patients.
Article Abstract
Objective: To identify risk factors for functional decline after hospitalization for Gram-negative bacteremia.
Patients And Methods: A prospective cohort study based on a randomized controlled trial conducted between January 1, 2013 and August 31, 2017 in Israel and Italy. Hospitalized patients with Gram-negative bacteremia who survived until day 90 and were not bedridden at baseline were included. The primary end point was functional decline at 90 days.
Results: Five hundred and nine patients were included. The median age of the cohort was 71 years (interquartile range [IQR], 60-80 years), 46.4% (236/509) were male and 352 of 509 (69%) patients were independent at baseline. Functional decline at 90 days occurred in 24.4% of patients (124/509). In multivariable analysis; older age (odds ratio [OR], 1.03; for an one-year increment, 95% confidence interval [CI] 1.01-1.05), functional dependence in instrumental activities of daily living at baseline (OR, 4.64; 95% CI 2.5-8.6), low Norton score (OR, 0.87; 95% CI 0.79-0.96) and underlying comorbidities: cancer (OR, 2.01; 95% CI 1.14-3.55) and chronic pulmonary disease (OR, 2.23 95% CI 1.12-4.42) and longer length of hospital stay (OR 1.09; for one-day increment, 95% CI 1.04-1.15) were associated with functional decline. Appropriate empirical antibiotic treatment was associated with lower rates of functional decline within 90 days (OR, 0.4; 95% CI 0.21-0.78).
Conclusions: Patients surviving bloodstream infections have poor long term trajectories after clinical recovery and hospital discharge. This has vast implications for patients, their family members and health policy makers.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8598031 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259707 | PLOS |
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