Survival Impact and Clinical Predictors of Acute Gastrointestinal Bleeding in Patients With Bloodstream Infection

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...

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Published in:Journal of intensive care medicine 2021-01, Vol.36 (1), p.63-69
Main Authors: Huang, Amy Huaishiuan, Liu, Ye, Hsien, Yenh-Chen, Hsu, Tzu-Chun, Yen, Debra, Hsu, Wan-Ting, Lin, Hsin-Yang, Chen, Shyr-Chyr, Lee, Chien-Chang
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Bacteremia - complications
Bacteremia - mortality
Gastrointestinal Hemorrhage - complications
Humans
Retrospective Studies
Risk Factors
Sepsis - complications
Sepsis - mortality
Taiwan
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Summary: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.
ISSN:0885-0666
1525-1489
DOI:10.1177/0885066619884896