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Atypical Presentation of Bacteremia in Older Patients Is a Risk Factor for Death

dc.rights.licenseopenen_US
dc.contributor.authorHYERNARD, Caroline
dc.contributor.authorBREINING, Alice
dc.contributor.authorDUC, Sophie
dc.contributor.authorKOBEH, David
dc.contributor.authorDUBOS, Maria
dc.contributor.authorPREVEL, Renaud
dc.contributor.authorCAZANAVE, Charles
dc.contributor.authorLAMBERT, Mathieu
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBONNET, Fabrice
dc.contributor.authorMERCIE, Patrick
dc.contributor.authorCONTIS, Anne
dc.contributor.authorDUFFAU, Pierre
dc.contributor.authorCAMOU, Fabrice
dc.contributor.authorGUERVILLE, Florent
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorRAINFRAY, Muriel
dc.contributor.authorROUBAUD-BAUDRON, Claire
dc.date.accessioned2020-06-23T08:57:55Z
dc.date.available2020-06-23T08:57:55Z
dc.date.issued2019-11
dc.identifier.issn0002-9343en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/8100
dc.description.abstractEnBACKGROUND: The absence of fever in bacteremia in patients who are older is known to delay diagnosis. Our objective was to determine whether atypical presentation was associated to mortality as a result of bacteremia in this patient cohort as well as possible factors associated with this atypical presentation. METHODS: We conducted an observational prospective study in 2 French university hospitals in 2016-2017 including patients ages >/=75 years with bacteremia. Atypical presentation was defined as the absence of a temperature >/=38.3 degrees C or <36 degrees C, chills, or hypotension. Mortality and dependence for activities of daily living (ADL) were recorded at 1 week (D7) and 3 months (D90). RESULTS: Among the 151 patients (mean age 85.4+/-5.8 years) enrolled, atypical presentation prevalence was 21.2%. D7 and D90 mortality rates were 7.9% and 40.0%, respectively. Atypical presentation was independently associated with D7 (odds ratio (OR) 4.46, 95% confidence interval (CI) 1.04-19.24) and D90 mortality (OR 3.76, 95% CI 1.30-10.92) after controlling for other prognostic factors. Patients with diabetes and those infected with Staphylococcus aureus were more likely to have atypical signs of infection. ADL score decreased from 3.6+/-2.0 before bacteremia to 2.8+/-2.1 at D90 (P <0.001). CONCLUSION: Patients who are older with bacteremia have poor vital and functional prognoses in the short and long terms. The absence of typical signs of infection is associated with mortality. Blood culture should be considered for patients who are older, especially with diabetes with acute unexplained clinical manifestations.
dc.language.isoENen_US
dc.subject.enEPICENE
dc.title.enAtypical Presentation of Bacteremia in Older Patients Is a Risk Factor for Death
dc.title.alternativeAm J Meden_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.amjmed.2019.04.049en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed31163127en_US
bordeaux.journalThe American Journal of Medicineen_US
bordeaux.page1344-1352.e1en_US
bordeaux.volume132en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue11en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamEPICENE_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03209278
hal.version1
hal.date.transferred2021-04-27T08:25:04Z
hal.exporttrue
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