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Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients

Stijn Blot (UGent) , Mustafa Cankurtaran, Mirko Petrovic (UGent) , Dominique Vandijck (UGent) , Christelle Lizy (UGent) , Johan Decruyenaere (UGent) , Christian Danneels (UGent) , Koenraad Vandewoude (UGent) , Anne Piette (UGent) , Gerda Verschraegen (UGent) , et al.
(2009) CRITICAL CARE MEDICINE. 37(5). p.1634-1641
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Abstract
Background: We investigated the epidemiology of nosocomial bloodstream infection in elderly intensive care unit (ICU) patients. Methods: In a single-center, historical cohort study (19922006), we compared middle-aged (45-64 years; n = 524), old (65-74 years; n = 326), and very old ICU patients (>= 75 years; n = 134) who developed a nosocomial bloodstream infection during their ICU stay. Results: Although the total number of ICU admissions (patients aged >= 45 years) decreased by similar to 10%, the number of very old patients increased by 33% between the periods 1992-1996 and 2002-2006. The prevalence of bloodstream infection (per 1,000 ICU admissions) increased significantly over time among old (p = 0.001) and very old patients (p = 0.002), but not among middle-aged patients (p = 0.232). Yet, this trend could not be confirmed with the incidence data expressed per 1,000 patient days (p > 0.05). Among patients with bloodstream infection, the proportion of very old patients increased significantly with time from 7.2% (1992-1996) to 13.5% (1997-2001) and 17.4% (2002-2006) (p < 0.001). The incidence of bloodstream infection (per 1000 patient days) decreased with age: 8.4 parts per thousand in middle-aged, 5.5 parts per thousand in old, and 4.6 parts per thousand in very old patients (p < 0.001). Mortality rates increased with age: 42.9%, 49.1%, and 56.0% for middle-aged, old, and very old patients, respectively (p = 0.015). Regression analysis revealed that the adjusted relationship with mortality was borderline significant for old age (hazard ratio, 1.2; 95% confidence interval, 1.0-1.5) and significant for very old age (hazard ratio, 1.8; 95% confidence interval, 1.4-2.4). Conclusion: Over the past 15 years, an increasing number of elderly patients were admitted to our ICU. The incidence of nosocomial bloodstream infection is lower among very old ICU patients when compared to middle-aged and old patients. Yet, the adverse impact of this infection is higher in very old patients.
Keywords
bloodstream, elderly, mortality, INTENSIVE-CARE-UNIT, STAPHYLOCOCCUS-AUREUS BACTEREMIA, PSEUDOMONAS-AERUGINOSA, ATTRIBUTABLE MORTALITY, ANTIMICROBIAL RESISTANCE, SURVEILLANCE CULTURES, SEPTIC SHOCK, RISK-FACTORS, IMPACT, LENGTH

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MLA
Blot, Stijn et al. “Epidemiology and Outcome of Nosocomial Bloodstream Infection in Elderly Critically Ill Patients: a Comparison Between Middle-aged, Old, and Very Old Patients.” CRITICAL CARE MEDICINE 37.5 (2009): 1634–1641. Print.
APA
Blot, S., Cankurtaran, M., Petrovic, M., Vandijck, D., Lizy, C., Decruyenaere, J., Danneels, C., et al. (2009). Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients. CRITICAL CARE MEDICINE, 37(5), 1634–1641.
Chicago author-date
Blot, Stijn, Mustafa Cankurtaran, Mirko Petrovic, Dominique Vandijck, Christelle Lizy, Johan Decruyenaere, Christian Danneels, et al. 2009. “Epidemiology and Outcome of Nosocomial Bloodstream Infection in Elderly Critically Ill Patients: a Comparison Between Middle-aged, Old, and Very Old Patients.” Critical Care Medicine 37 (5): 1634–1641.
Chicago author-date (all authors)
Blot, Stijn, Mustafa Cankurtaran, Mirko Petrovic, Dominique Vandijck, Christelle Lizy, Johan Decruyenaere, Christian Danneels, Koenraad Vandewoude, Anne Piette, Gerda Verschraegen, Nele Van Den Noortgate, Renaat Peleman, and Dirk Vogelaers. 2009. “Epidemiology and Outcome of Nosocomial Bloodstream Infection in Elderly Critically Ill Patients: a Comparison Between Middle-aged, Old, and Very Old Patients.” Critical Care Medicine 37 (5): 1634–1641.
Vancouver
1.
Blot S, Cankurtaran M, Petrovic M, Vandijck D, Lizy C, Decruyenaere J, et al. Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients. CRITICAL CARE MEDICINE. 2009;37(5):1634–41.
IEEE
[1]
S. Blot et al., “Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients,” CRITICAL CARE MEDICINE, vol. 37, no. 5, pp. 1634–1641, 2009.
@article{694722,
  abstract     = {Background: We investigated the epidemiology of nosocomial bloodstream infection in elderly intensive care unit (ICU) patients.
Methods: In a single-center, historical cohort study (19922006), we compared middle-aged (45-64 years; n = 524), old (65-74 years; n = 326), and very old ICU patients (>= 75 years; n = 134) who developed a nosocomial bloodstream infection during their ICU stay.
Results: Although the total number of ICU admissions (patients aged >= 45 years) decreased by similar to 10%, the number of very old patients increased by 33% between the periods 1992-1996 and 2002-2006. The prevalence of bloodstream infection (per 1,000 ICU admissions) increased significantly over time among old (p = 0.001) and very old patients (p = 0.002), but not among middle-aged patients (p = 0.232). Yet, this trend could not be confirmed with the incidence data expressed per 1,000 patient days (p > 0.05). Among patients with bloodstream infection, the proportion of very old patients increased significantly with time from 7.2% (1992-1996) to 13.5% (1997-2001) and 17.4% (2002-2006) (p < 0.001). The incidence of bloodstream infection (per 1000 patient days) decreased with age: 8.4 parts per thousand in middle-aged, 5.5 parts per thousand in old, and 4.6 parts per thousand in very old patients (p < 0.001). Mortality rates increased with age: 42.9%, 49.1%, and 56.0% for middle-aged, old, and very old patients, respectively (p = 0.015). Regression analysis revealed that the adjusted relationship with mortality was borderline significant for old age (hazard ratio, 1.2; 95% confidence interval, 1.0-1.5) and significant for very old age (hazard ratio, 1.8; 95% confidence interval, 1.4-2.4).
Conclusion: Over the past 15 years, an increasing number of elderly patients were admitted to our ICU. The incidence of nosocomial bloodstream infection is lower among very old ICU patients when compared to middle-aged and old patients. Yet, the adverse impact of this infection is higher in very old patients.},
  author       = {Blot, Stijn and Cankurtaran, Mustafa and Petrovic, Mirko and Vandijck, Dominique and Lizy, Christelle and Decruyenaere, Johan and Danneels, Christian and Vandewoude, Koenraad and Piette, Anne and Verschraegen, Gerda and Van Den Noortgate, Nele and Peleman, Renaat and Vogelaers, Dirk},
  issn         = {0090-3493},
  journal      = {CRITICAL CARE MEDICINE},
  keywords     = {bloodstream,elderly,mortality,INTENSIVE-CARE-UNIT,STAPHYLOCOCCUS-AUREUS BACTEREMIA,PSEUDOMONAS-AERUGINOSA,ATTRIBUTABLE MORTALITY,ANTIMICROBIAL RESISTANCE,SURVEILLANCE CULTURES,SEPTIC SHOCK,RISK-FACTORS,IMPACT,LENGTH},
  language     = {eng},
  number       = {5},
  pages        = {1634--1641},
  title        = {Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients},
  url          = {http://dx.doi.org/10.1097/CCM.0b013e31819da98e},
  volume       = {37},
  year         = {2009},
}

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