Improving survival of patients with candidaemia: analysis of prognostic factors from a long-term, nationwide study in Iceland

2.50
Hdl Handle:
http://hdl.handle.net/2336/66414
Title:
Improving survival of patients with candidaemia: analysis of prognostic factors from a long-term, nationwide study in Iceland
Authors:
Asmundsdóttir, Lena Ros; Erlendsdottir, Helga; Gottfredsson, Magnus
Citation:
Scand. J. Infect. Dis. 2005, 37(2):111-20
Issue Date:
1-Feb-2005
Abstract:
A population-based epidemiological and clinical study of candidaemia in Iceland was conducted during a 20-y period, 1980-1999. As previously reported, the incidence of candidaemia increased 3.5-fold during the study period, without major changes in species distribution or antifungal resistance (Asmundsdottir et al., J Clin Microbiol 2002;40:3489-92). In this study detailed clinical information was collected and registered on all candidaemic patients (n=165, episodes n=172) in Iceland during 1980-1999. Clinical characteristics were compared between adults and children. Univariate and multivariate analyses were used to determine predictors of 30-d mortality. In comparison with adults, young children with candidaemia more often presented with respiratory distress, without fever p<0.001. Adult patients were more likely to have underlying malignancies (p=0.009) and to have undergone surgical operations (p=0.002). During the study a steady decrease in 30-d case fatality ratio was noted, from 58.8% in 1980-1984, to 26.7% in 1995-1999 (p=0.02). At the same time a more aggressive approach to candidaemia management was documented. In multivariate analysis, prompt removal of central venous catheters (odds ratio for death, 0.22, p=0.004), and septic shock (odds ratio for death, 8.01, p=0.001) were the strongest independent predictors of outcome. Our results underline the strong association between prompt removal of vascular catheters and favourable outcome, suggesting that mortality may be reduced by more aggressive management.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.informaworld.com/10.1080/00365540510026814

Full metadata record

DC FieldValue Language
dc.contributor.authorAsmundsdóttir, Lena Ros-
dc.contributor.authorErlendsdottir, Helga-
dc.contributor.authorGottfredsson, Magnus-
dc.date.accessioned2009-04-27T14:13:45Z-
dc.date.available2009-04-27T14:13:45Z-
dc.date.issued2005-02-01-
dc.date.submitted2009-04-27-
dc.identifier.citationScand. J. Infect. Dis. 2005, 37(2):111-20en
dc.identifier.issn0036-5548-
dc.identifier.pmid15764202-
dc.identifier.doi10.1080/00365540510026814-
dc.identifier.urihttp://hdl.handle.net/2336/66414-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractA population-based epidemiological and clinical study of candidaemia in Iceland was conducted during a 20-y period, 1980-1999. As previously reported, the incidence of candidaemia increased 3.5-fold during the study period, without major changes in species distribution or antifungal resistance (Asmundsdottir et al., J Clin Microbiol 2002;40:3489-92). In this study detailed clinical information was collected and registered on all candidaemic patients (n=165, episodes n=172) in Iceland during 1980-1999. Clinical characteristics were compared between adults and children. Univariate and multivariate analyses were used to determine predictors of 30-d mortality. In comparison with adults, young children with candidaemia more often presented with respiratory distress, without fever p<0.001. Adult patients were more likely to have underlying malignancies (p=0.009) and to have undergone surgical operations (p=0.002). During the study a steady decrease in 30-d case fatality ratio was noted, from 58.8% in 1980-1984, to 26.7% in 1995-1999 (p=0.02). At the same time a more aggressive approach to candidaemia management was documented. In multivariate analysis, prompt removal of central venous catheters (odds ratio for death, 0.22, p=0.004), and septic shock (odds ratio for death, 8.01, p=0.001) were the strongest independent predictors of outcome. Our results underline the strong association between prompt removal of vascular catheters and favourable outcome, suggesting that mortality may be reduced by more aggressive management.en
dc.language.isoenen
dc.publisherTaylor & Francisen
dc.relation.urlhttp://www.informaworld.com/10.1080/00365540510026814en
dc.subject.meshAdolescenten
dc.titleImproving survival of patients with candidaemia: analysis of prognostic factors from a long-term, nationwide study in Icelanden
dc.typeArticleen
dc.contributor.departmentUniversity of Iceland Medical School, Vatnsmýrarvegi, Reykjavik, Iceland.en
dc.identifier.journalScandinavian journal of infectious diseasesen

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