Gastrointestinal symptoms in invasive pneumococcal disease: a cohort study.
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents
/ therapeutic use
Comorbidity
Female
Gastrointestinal Diseases
/ drug therapy
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Norway
/ epidemiology
Pneumococcal Infections
/ drug therapy
Proportional Hazards Models
Prospective Studies
Retrospective Studies
Risk Factors
Streptococcus pneumoniae
/ immunology
Treatment Outcome
Young Adult
Gastrointestinal symptoms
Invasive pneumococcal disease
Mortality
Pneumococcal bacteremia
Sepsis
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
06 Jul 2020
06 Jul 2020
Historique:
received:
01
03
2020
accepted:
29
06
2020
entrez:
8
7
2020
pubmed:
8
7
2020
medline:
16
7
2020
Statut:
epublish
Résumé
The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD). We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993 to 2008. Clinical data were registered. Survival data were retrieved from official registries. We used Cox regression and Kaplan-Meier curve to compare mortality within 28 days of admission in patients with and without GI symptoms. Four hundred sixteen patients were included. Of these, 108 patients (26%) presented with GI symptoms, and 47 patients (11%) with GI symptoms only. Patients with GI symptoms were younger (p < 0.001) and had less cardiovascular disease (p < 0.001), pulmonary disease (p = 0.048), and cancer (p = 0.035) and received appropriate antibiotic treatment later. After adjusting for risk factors, we found an increased hazard ratio of 2.28 (95% CI 1.31-3.97) in patients presenting with GI symptoms. In patients with GI symptoms only there was an increased hazard ratio of 2.24 (95% CI 1.20-4.19) in univariate analysis, which increased to 4.20 (95% CI 2.11-8.39) after multivariate adjustment. Fewer patients with GI symptoms only received antibiotics upon admission. A large proportion of IPD patients present with GI symptoms only or in combination with other symptoms. GI symptoms in IPD are associated with increased short-term mortality.
Sections du résumé
BACKGROUND
BACKGROUND
The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD).
METHODS
METHODS
We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993 to 2008. Clinical data were registered. Survival data were retrieved from official registries. We used Cox regression and Kaplan-Meier curve to compare mortality within 28 days of admission in patients with and without GI symptoms.
RESULTS
RESULTS
Four hundred sixteen patients were included. Of these, 108 patients (26%) presented with GI symptoms, and 47 patients (11%) with GI symptoms only. Patients with GI symptoms were younger (p < 0.001) and had less cardiovascular disease (p < 0.001), pulmonary disease (p = 0.048), and cancer (p = 0.035) and received appropriate antibiotic treatment later. After adjusting for risk factors, we found an increased hazard ratio of 2.28 (95% CI 1.31-3.97) in patients presenting with GI symptoms. In patients with GI symptoms only there was an increased hazard ratio of 2.24 (95% CI 1.20-4.19) in univariate analysis, which increased to 4.20 (95% CI 2.11-8.39) after multivariate adjustment. Fewer patients with GI symptoms only received antibiotics upon admission.
CONCLUSIONS
CONCLUSIONS
A large proportion of IPD patients present with GI symptoms only or in combination with other symptoms. GI symptoms in IPD are associated with increased short-term mortality.
Identifiants
pubmed: 32631331
doi: 10.1186/s12879-020-05211-3
pii: 10.1186/s12879-020-05211-3
pmc: PMC7339559
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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