TY - JOUR
T1 - Survival Impact and Clinical Predictors of Acute Gastrointestinal Bleeding in Patients With Bloodstream Infection
AU - NTUH Health Data Science Research Group
AU - Huang, Amy Huaishiuan
AU - Liu, Ye
AU - Hsien, Yenh Chen
AU - Hsu, Tzu Chun
AU - Yen, Debra
AU - Hsu, Wan Ting
AU - Lin, Hsin Yang
AU - Chen, Shyr Chyr
AU - Lee, Chien Chang
N1 - Funding Information:
Gastrointestinal bleeding had an adverse impact on the short-term survival in patients with BSI. The clinical predictors may help identify patients who may benefit from active prevention and treatment of GIB. bloodstream infection gastrointestinal bleeding propensity score sepsis inverse probability of treatment weighting (IPTW) National Taiwan University Hospital Research Grant NTUH106-P04 edited-state corrected-proof Authors’ Note Chien-Chang Lee conceived and designed the study. Yenh-Chen Hsien, Wan-Ting Hsu, Hsin-Yang Lin, and Shyr-Chyr Chen reviewed the electronic medical records and extracted the data. Yenh-Chen Hsien was responsible for the laboratory tests. Tzu-Chun Hsu and Chien-Chang Lee performed the statistical analysis. Amy Huaishiuan Huang, Ye Liu and Chien-Chang Lee interpreted the analysis results and drafted the manuscript. Amy Huaishiuan Huang, Ye Liu, Debra Yen, Wan-Ting Hsu, and Chien-Chang Lee critically reviewed and revised the manuscript. Chien-Chang Lee supervised the study and provided quality control and takes responsibility for the paper as a whole. All authors read and approved the final manuscript. Chien-Chang Lee is the Guarantor of the article.
Publisher Copyright:
© The Author(s) 2019.
PY - 2021/1
Y1 - 2021/1
N2 - Purpose: The impact of gastrointestinal bleeding (GIB) on outcomes of patients with bloodstream infection (BSI) has not been studied. We aim to evaluate the risk factors and survival impact of GIB on the outcome of BSI. Materials and Methods: This study was conducted prospectively at National Taiwan University Hospital Yunlin Branch between January 1, 2015, and December 31, 2016. Patients aged ≥18 years for who BSI was confirmed by blood cultures were enrolled and followed for 90 days. Risk factors of GIB were identified by univariable and multivariable logistic regression models. The survival impact of GIB on BSI was evaluated with the Cox proportional hazards model with inverse probability of treatment weighting. Results: Of the 1034 patients with BSI, 79 (7.64%) developed acute GIB. We identified 5 independent predictors of GIB. Patients with BSI complicated with GIB had an increased 90-day mortality compared to patients without GIB (hazard ratio 1.74, 95% confidence interval: 1.14, 2.65). Conclusions: Gastrointestinal bleeding had an adverse impact on the short-term survival in patients with BSI. The clinical predictors may help identify patients who may benefit from active prevention and treatment of GIB.
AB - Purpose: The impact of gastrointestinal bleeding (GIB) on outcomes of patients with bloodstream infection (BSI) has not been studied. We aim to evaluate the risk factors and survival impact of GIB on the outcome of BSI. Materials and Methods: This study was conducted prospectively at National Taiwan University Hospital Yunlin Branch between January 1, 2015, and December 31, 2016. Patients aged ≥18 years for who BSI was confirmed by blood cultures were enrolled and followed for 90 days. Risk factors of GIB were identified by univariable and multivariable logistic regression models. The survival impact of GIB on BSI was evaluated with the Cox proportional hazards model with inverse probability of treatment weighting. Results: Of the 1034 patients with BSI, 79 (7.64%) developed acute GIB. We identified 5 independent predictors of GIB. Patients with BSI complicated with GIB had an increased 90-day mortality compared to patients without GIB (hazard ratio 1.74, 95% confidence interval: 1.14, 2.65). Conclusions: Gastrointestinal bleeding had an adverse impact on the short-term survival in patients with BSI. The clinical predictors may help identify patients who may benefit from active prevention and treatment of GIB.
KW - bloodstream infection
KW - gastrointestinal bleeding
KW - inverse probability of treatment weighting (IPTW)
KW - propensity score
KW - sepsis
UR - http://www.scopus.com/inward/record.url?scp=85074843129&partnerID=8YFLogxK
U2 - 10.1177/0885066619884896
DO - 10.1177/0885066619884896
M3 - Article
C2 - 31684828
AN - SCOPUS:85074843129
SN - 0885-0666
VL - 36
SP - 63
EP - 69
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 1
ER -