Universität zu Köln

Nambiar, Kate ORCID: 0000-0001-8591-0203, Seifert, Harald, Rieg, Siegbert, Kern, Winfried, V, Scarborough, Matt, Gordon, N. Claire, Kim, Hong Bin, Song, Kyoung-Ho ORCID: 0000-0002-4517-3840, Tilley, Robert, Gott, Hannah, Liao, Chun Hsing, Edgeworth, Jonathan, Nsutebu, Emmanuel, Eduardo Lopez-Cortes, Luis, Morat, Laura, Walke, A. Sarah, Thwaites, Guy, Llewelyn, Martin J. and Kaasch, Achim J. (2018). Survival following Staphylococcus aureus bloodstream infection: A prospective multinational cohort study assessing the impact of place of care. J. Infect., 77 (6). S. 516 - 526. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2742

Full text not available from this repository.

Abstract

Background: Staphylococcus aureus bloodstream infection (SAB) is a common, life-threatening infection with a high mortality. Survival can be improved by implementing quality of care bundles in hospitals. We previously observed marked differences in mortality between hospitals and now assessed whether mortality could serve as a valid and easy to implement quality of care outcome measure. Methods: We conducted a prospective observational study between January 2013 and April 2015 on consecutive, adult patients with SAB from 11 tertiary care centers in Germany, South Korea, Spain, Taiwan, and the United Kingdom. Factors associated with mortality at 90 days were analyzed by Cox proportional hazards regression and flexible parametric models. Results: 1851 patients with a median age of 66 years (64% male) were analyzed. Crude 90-day mortality differed significantly between hospitals (range 23-39%). Significant variation between centers was observed for methicillin-resistant S. aureus, community-acquisition, infective foci, as well as measures of comorbidities, and severity of disease. In multivariable analysis, factors independently associated with mortality at 90 days were age, nosocomial acquisition, unknown infective focus, pneumonia, Charlson comorbidity index, SOFA score, and study center. The risk of death varied over time differently for each infective focus. Crude mortality differed markedly from adjusted mortality. Discussion: We observed significant differences in adjusted mortality between hospitals, suggesting differences in quality of care. However, mortality is strongly influenced by patient mix and thus, crude mortality is not a suitable quality indicator. (C) 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nambiar, Kate UNSPECIFIED orcid.org/0000-0001-8591-0203 UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Scarborough, Matt UNSPECIFIED UNSPECIFIED UNSPECIFIED Gordon, N. Claire UNSPECIFIED UNSPECIFIED UNSPECIFIED Kim, Hong Bin UNSPECIFIED UNSPECIFIED UNSPECIFIED Song, Kyoung-Ho UNSPECIFIED orcid.org/0000-0002-4517-3840 UNSPECIFIED Tilley, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Gott, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Liao, Chun Hsing UNSPECIFIED UNSPECIFIED UNSPECIFIED Edgeworth, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nsutebu, Emmanuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Eduardo Lopez-Cortes, Luis UNSPECIFIED UNSPECIFIED UNSPECIFIED Morat, Laura UNSPECIFIED UNSPECIFIED UNSPECIFIED Walke, A. Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Thwaites, Guy UNSPECIFIED UNSPECIFIED UNSPECIFIED Llewelyn, Martin J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaasch, Achim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164003
DOI:	10.1016/j.jinf.2018.08.015
Journal or Publication Title:	J. Infect.
Volume:	77
Number:	6
Page Range:	S. 516 - 526
Date:	2018
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2742
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BACTEREMIA; MANAGEMENT; MORTALITY; RESISTANT Multiple languages Infectious Diseases Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16400