Epidemiology and outcome of sepsis in adult patients with Streptococcus pneumoniae infection in a Norwegian county 1993–2011: an observational study

90-day mortality in relation to patient characteristics prior to infection. Table S1a. 90-day mortality in relation to gender. Table S2. 90-day mortality in relation to disease acquisition, severity, focus and time period. (DOCX 22 kb

Epidemiology and outcome of Staphylococcus aureusbloodstream infection and sepsis in a Norwegian county 1996–2011: an observational study

Background: Staphylococcus aureus is one of the most common and lethal causes of bloodstream infection and the incidence is increasing. We carried out a prospective observational study of patients with Staphylococcus aureus bloodstream infection and sepsis in Nord-Trøndelag county in Norway from 1996–2011. The main outcome of interest was all-cause mortality within 30 and 90 days. Methods: Positive blood cultures were registered prospectively by the microbiology laboratory and clinical variables were retrospectively registered from patients’ hospital records. The severity of sepsis was assigned according to the 2001 International Sepsis Definition Conference criteria. The association between clinical characteristics and mortality was studied using logistic regression analysis, and adjusted 30- and 90-day mortality risks were estimated. Results: Among 373 patients, the median age was 74 years and 60.3% were male. 0.8% of the patients were diagnosed with MRSA. 29.8% of the patients developed severe sepsis and 12.9% developed septic shock. The all-cause mortality was 14.5%, 27.3% and 36.2% at 7, 30 and 90 days, respectively. Compared to patients with sepsis without organ failure (Mortality risk 13.3%, 95% CI 7.5-16.3%), the 30-day mortality risk was 3-fold higher among those with severe sepsis (39.9%, 95% CI 29.5-48.5%) and more than 4-fold higher for those with septic shock (57.3%, 95% CI 42.5-72.2%). The 30-day all-cause mortality varied by focus of infection, with the highest 30-day mortality risk among those with a pulmonary focus (42.4%, 95% CI 26.0-58.5%) and unknown focus of infection (38.7%, 95% CI 27.5-48.2%). The mortality risk did not differ between the first and second halves of the study period with a 30-day mortality risk of 27.3%, (95% CI 18.1-33.1%) for 1996–2003 versus 27.4% (95% CI 19.4-31.4%) for 2004–2011. The same pattern was seen for 90-day mortality risk. Conclusion: Staphylococcus aureus bloodstream infection carries a high case fatality rate, especially among those with severe sepsis and septic shock and among those with a pulmonary or unknown focus of infection. There was no decrease in 30- or 90-day mortality risk during the study period. This underscores the importance of continuing surveillance and efforts to improve the outcome of this serious disease.© 2015 Paulsen et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Associations of obesity and lifestyle with the risk and mortality of bloodstream infection in a general population: a 15-year follow-up of 64 027 individuals in the HUNT Study

Background: Bloodstream infections (BSI) cause considerable morbidity and mortality, and primary prevention should be a priority. Lifestyle factors are of particular interest since they represent a modifiable target. Methods: We conducted a prospective cohort study among participants in the population-based Norwegian HUNT2 Survey, where 64 027 participants were followed from 1995–97 through 2011 by linkage to prospectively recorded information on BSI at local and regional hospitals. The exposures were: baseline body mass index (BMI) measurements; and self-reported smoking habits, leisure time physical activity and alcohol intake. The outcomes were hazard ratios (HR) of BSI and BSI mortality. Results: During 810 453 person-years and median follow-up of 14.8 years, 1844 (2.9%) participants experienced at least one BSI and 396 (0.62%) died from BSI. Compared with normal weight participants (BMI 18.5–24.9 kg/m2), the age- and sex-adjusted risk of a first-time BSI was 31% [95% confidence interval (CI) 14–51%] higher at BMI 30.0–34.9 kg/m2, 87% (95% CI 50–135%) higher at BMI 35.0–39.9 kg/m2 and 210% (95% CI 117–341%) higher at BMI ≥ 40.0 kg/m2. The risk of BSI mortality was similarly increased. Compared with never-smokers, current smokers had 51% (95% CI 34–70%) and 75% (95% CI 34–129%) higher risks of BSI and BSI mortality, respectively. Physically inactive participants had 71% (95% CI 42–107%) and 108% (95% CI 37–216%) higher risks of BSI and BSI mortality, respectively, compared with the most physically active

Additional file 2: Table S2. of Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality – a prospective study of patients admitted with infection to the emergency department

Detailed information on missing values bye age group and triage category. (DOCX 12 kb

El Buscapié : periódico satírico de noticias y anuncios: Ano II Número 87 - 28 decembro 1867

ROC Area for 7 and 30 days mortality in Complete Case and Multiple Imputation analysis. (DOCX 23 kb

Explaining sex differences in risk of bloodstream infections using mediation analysis in the population-based HUNT study in Norway

Previous studies indicate sex differences in incidence and severity of bloodstream infections (BSI). We examined the effect of sex on risk of BSI, BSI mortality, and BSI caused by the most common infecting bacteria. Using causal mediation analyses, we assessed if this effect is mediated by health behaviours (smoking, alcohol consumption), education, cardiovascular risk factors (systolic blood pressure, non-HDL cholesterol, body mass index) and selected comorbidities (cardiovascular disease, chronic kidney disease, diabetes, cancer history and chronic lung disease). This prospective study included 64,040 participants (46.8% men) in the population-based HUNT2 Survey (1995−97) linked with hospital records in incident BSI. During median follow-up of 14.8 years, 1840 (2.9%) participants (51.3% men) experienced a BSI and 396 (0.6%) died (56.6% men). Men had 41% higher risk of first-time BSI (95% confidence interval (CI), 28−54%) than women. Together, health behaviours, education, cardiovascular risk factors and the selected comorbidities mediated 34% of the excess risk of BSI observed in men. The HR of BSI mortality was 1.87 (95%CI, 1.53−2.28), for BSI due to S. aureus 2.09 (1.28−2.54), S. pneumoniae 1.36 (1.05−1.76), and E. coli 0.97 (0.84−1.13) in men vs women. This population-based study shows that men have higher risk of BSI and BSI mortality than women. One-third of this effect was mediated by potential modifiable risk factors for incident BSI

Explaining sex differences in risk of bloodstream infections using mediation analysis in the population-based HUNT study in Norway

Previous studies indicate sex differences in incidence and severity of bloodstream infections (BSI). We examined the effect of sex on risk of BSI, BSI mortality, and BSI caused by the most common infecting bacteria. Using causal mediation analyses, we assessed if this effect is mediated by health behaviours (smoking, alcohol consumption), education, cardiovascular risk factors (systolic blood pressure, non-HDL cholesterol, body mass index) and selected comorbidities (cardiovascular disease, chronic kidney disease, diabetes, cancer history and chronic lung disease). This prospective study included 64,040 participants (46.8% men) in the population-based HUNT2 Survey (1995−97) linked with hospital records in incident BSI. During median follow-up of 14.8 years, 1840 (2.9%) participants (51.3% men) experienced a BSI and 396 (0.6%) died (56.6% men). Men had 41% higher risk of first-time BSI (95% confidence interval (CI), 28−54%) than women. Together, health behaviours, education, cardiovascular risk factors and the selected comorbidities mediated 34% of the excess risk of BSI observed in men. The HR of BSI mortality was 1.87 (95%CI, 1.53−2.28), for BSI due to S. aureus 2.09 (1.28−2.54), S. pneumoniae 1.36 (1.05−1.76), and E. coli 0.97 (0.84−1.13) in men vs women. This population-based study shows that men have higher risk of BSI and BSI mortality than women. One-third of this effect was mediated by potential modifiable risk factors for incident BSI

Explaining sex differences in risk of bloodstream infections using mediation analysis in the population-based HUNT study in Norway

Previous studies indicate sex differences in incidence and severity of bloodstream infections (BSI). We examined the effect of sex on risk of BSI, BSI mortality, and BSI caused by the most common infecting bacteria. Using causal mediation analyses, we assessed if this effect is mediated by health behaviours (smoking, alcohol consumption), education, cardiovascular risk factors (systolic blood pressure, non-HDL cholesterol, body mass index) and selected comorbidities (cardiovascular disease, chronic kidney disease, diabetes, cancer history and chronic lung disease). This prospective study included 64,040 participants (46.8% men) in the population-based HUNT2 Survey (1995−97) linked with hospital records in incident BSI. During median follow-up of 14.8 years, 1840 (2.9%) participants (51.3% men) experienced a BSI and 396 (0.6%) died (56.6% men). Men had 41% higher risk of first-time BSI (95% confidence interval (CI), 28−54%) than women. Together, health behaviours, education, cardiovascular risk factors and the selected comorbidities mediated 34% of the excess risk of BSI observed in men. The HR of BSI mortality was 1.87 (95%CI, 1.53−2.28), for BSI due to S. aureus 2.09 (1.28−2.54), S. pneumoniae 1.36 (1.05−1.76), and E. coli 0.97 (0.84−1.13) in men vs women. This population-based study shows that men have higher risk of BSI and BSI mortality than women. One-third of this effect was mediated by potential modifiable risk factors for incident BSI