TABLE 1.
Age-related trends in various clinical characteristics and outcomes of 2,349 patients with community-onset bacteremia
| Characteristic | No. (%) of patients |
P valuea | |||
|---|---|---|---|---|---|
| Young adults (18–44 yr; n = 196) |
Adults (45–64 yr; n = 707) |
Elderly (65–84 yr; n = 1,098) |
Oldest old (≥85 yr; n = 348) |
||
| Gender, male | 105 (53.8) | 397 (56.2) | 509 (46.4) | 198 (56.9) | 0.987 |
| Nursing home residents | 4 (2.0) | 22 (3.1) | 62 (5.6) | 45 (12.9) | 0.073 |
| Recent events within 4 weeks before ED arrival | |||||
| Hospitalization | 36 (18.4) | 179 (25.3) | 265 (24.1) | 71 (20.4) | 0.807 |
| Antimicrobial therapy | 27 (13.8) | 137 (19.4) | 227 (20.7) | 55 (15.8) | 0.704 |
| Invasive proceduresb or surgery | 6 (3.1) | 55 (7.8) | 93 (8.5) | 18 (5.2) | 0.636 |
| Polymicrobial bacteremia | 17 (8.7) | 55 (7.8) | 116 (10.6) | 52 (14.9) | 0.125 |
| Major comorbidity | |||||
| Malignancy | 35 (17.9) | 213 (30.1) | 345 (31.4) | 66 (19.0) | 0.917 |
| Liver cirrhosis | 27 (13.8) | 127 (18.0) | 133 (12.1) | 14 (4.0) | 0.223 |
| Chronic kidney disease | 25 (12.8) | 99 (14.0) | 221 (20.1) | 74 (21.3) | 0.045 |
| Hypertension | 15 (7.7) | 231 (32.7) | 656 (59.7) | 216 (62.1) | 0.042 |
| Diabetes mellitus | 10 (5.1) | 255 (36.1) | 491 (44.7) | 119 (34.2) | 0.282 |
| Neurological disease | 7 (3.6) | 56 (7.9) | 297 (27.0) | 162 (46.6) | 0.030 |
| Urological disease | 8 (3.1) | 23 (3.3) | 88 (8.0) | 45 (12.9) | 0.051 |
| Coronary artery disease | 1 (0.5) | 27 (3.8) | 144 (13.1) | 51 (14.7) | 0.046 |
| Chronic obstructive pulmonary disease | 0 (0) | 16 (2.3) | 56 (5.1) | 40 (11.5) | 0.032 |
| Ultimately or rapidly fatal comorbidity (McCabe classification) | 42 (21.4) | 197 (27.9) | 273 (24.9) | 52 (14.9) | 0.480 |
| Major sources of bacteremia | |||||
| Urinary tract infection | 46 (23.5) | 210 (29.7) | 379 (34.5) | 113 (32.5) | 0.143 |
| Intra-abdominal infection | 38 (19.4) | 108 (15.3) | 136 (12.4) | 30 (8.6) | 0.002 |
| Skin and soft-tissue infection | 27 (13.8) | 85 (12.0) | 86 (7.8) | 46 (13.2) | 0.714 |
| Primary bacteremia | 25 (12.8) | 62 (8.8) | 72 (6.6) | 22 (6.3) | 0.066 |
| Pneumonia | 19 (9.7) | 77 (10.9) | 162 (14.8) | 67 (19.3) | 0.026 |
| Bone and joint infection | 16 (8.2) | 34 (4.8) | 37 (3.4) | 5 (1.4) | 0.017 |
| Biliary tract infection | 7 (3.6) | 46 (6.5) | 121 (11.0) | 46 (13.2) | 0.008 |
| Severity-of-illness marker at bacteremia onset (Pitt bacteremia score) | |||||
| ≥4 points | 26 (13.3) | 121 (17.1) | 233 (21.2) | 96 (27.6) | 0.008 |
| 0 points | 66 (33.7) | 203 (28.7) | 289 (26.3) | 75 (21.6) | 0.008 |
| Initial syndrome | |||||
| Severe sepsis | 53 (27.0) | 286 (40.5) | 510 (46.4) | 174 (50.0) | 0.043 |
| Septic shock | 28 (14.3) | 142 (20.1) | 226 (20.6) | 83 (23.9) | 0.052 |
| Length (days, mean ± SD) | |||||
| Time to defervescencec | 6.9 ± 7.9 | 7.8 ± 8.8 | 7.5 ± 8.4 | 7.5 ± 8.8 | 0.487 |
| Total hospital stay | 16.9 ± 25.5 | 14.5 ± 15.7 | 15.1 ± 16.5 | 14.0 ± 15.5 | 0.174 |
| Crude mortality rate | |||||
| 2 wk | 10 (5.1) | 72 (10.2) | 116 (10.6) | 53 (15.2) | 0.040 |
| 4 wk | 19 (9.7) | 99 (14.0) | 158 (14.4) | 64 (18.4) | 0.038 |
a
Calculated by Pearson's correlation. Boldface indicates statistical significance, i.e., a P value of <0.05.
b
Including endoscopic retrograde cholangiopancreatography, bronchoscopy, panendoscopy, and colonoscopy.
c
Only 1,905 febrile patients at admission were calculated.