Impact of total body weight on 30-day mortality in patients with gram-negative bacteremia

Expert Rev Anti Infect Ther. 2017 Aug;15(8):797-803. doi: 10.1080/14787210.2017.1328277. Epub 2017 May 17.

Abstract

Background: The impact of total body weight (TBW) on 30-day mortality associated with gram-negative bacteremia has not been previously evaluated.

Methods: The cohort included 323 patients >/ = 18 years old with gram-negative bacteremia (1/1/2008-8/31/2011) who received >/ = 48 hours of antibiotics. We compared 30-day mortality of TBW <70 kg vs. >/ = 70 kg with a multivariable stepwise logistic regression adjusting for age >/ = 70 years, cancer diagnosis, and Pitt bacteremia score of >/ = 4.

Results: The cohort was 57% TBW >/ = 70 kg and 43% TBW <70 kg. TBW >/ = 70 kg patients had lower 30-day mortality (11.0% vs. 16.3%), which was significant in the multivariable analysis (OR 0.45, 95% CI 0.21-0.97). Cancer and Pitt bacteremia score >/ = 4 were also independently associated with 30-day mortality. TBW was no longer significant when TBW <50 kg patients were excluded.

Conclusion: TBW >/ = 70 kg was associated with an improved 30-day mortality; however, the high mortality rates for patients with a TBW < 50 kg is responsible for this association.

Keywords: Escherichia coli; Gram-negative; Klebsiella sp; bacteremia; total body weight.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Bacteremia / mortality*
  • Body Weight*
  • Cohort Studies
  • Female
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Negative Bacterial Infections / mortality*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk

Substances

  • Anti-Bacterial Agents