Abstract:
:Bacteremic pneumococcal pneumonia (BPP) causes considerable mortality and morbidity. We aimed to identify prognostic factors associated with mortality and major in-hospital complications in BPP.A prospective, population-based clinical registry of 1636 hospitalized adult patients (≥18 years) with BPP was established between 2000 and 2010 in Northern Alberta, Canada. Prognostic factors for mortality and major in-hospital complications (e.g., cardiac events, mechanical ventilation, aspiration) were evaluated using multivariable logistic regression.Average age was 54 (standard deviation 18) years, 57% males, and 59% had high case-fatality rate (CFR) serotypes. Overall, 14% (226/1636) of patients died and 22% (315/1410) of survivors developed at least 1 complication. Independent prognostic factors for mortality were age (adjusted odds ratio [aOR], 1.5 per decade; 95% confidence interval [CI], 1.3-1.7), nursing home residence (aOR, 3.7; 95% CI 1.8-7.4), community-dwelling dementia (aOR 3.7; 95% CI, 1.6-8.6), alcohol abuse (aOR, 2.2; 95% CI, 1.4-3.4), acid-suppressing drugs (aOR, 1.5; 95% CI, 1.0-2.3), guideline-discordant antibiotics (aOR, 3.4; 95% CI, 2.4-4.8), multilobe pneumonia (aOR, 2.6; 95% CI, 1.8-3.6), and high CFR serotypes (aOR, 1.8; 95% CI, 1.2-2.8). Similar prognostic factors were observed for major in-hospital complications. Pneumococcal vaccination was associated with reduced in-hospital mortality (aOR, 0.2; 95% CI, 0.05-0.9) but not major complications (P = 0.2).Older and frailer patients, and those who abuse alcohol or take acid-suppressing drugs, are at increased risk of BPP-related mortality and complications, as are those with high CFR serotypes. Beyond identifying those at highest risk, our findings demonstrate the importance of guideline-concordant antibiotics and pneumococcal vaccination in those with BPP.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Beatty JA,Majumdar SR,Tyrrell GJ,Marrie TJ,Eurich DTdoi
10.1097/MD.0000000000005179subject
Has Abstractpub_date
2016-11-01 00:00:00pages
e5179issue
46eissn
0025-7974issn
1536-5964pii
00005792-201611150-00011journal_volume
95pub_type
杂志文章相关文献
MEDICINE文献大全abstract::Orthostatic hypotension (OH) is a common problem in the elderly age group, and some studies have reported an association between OH and increased mortality. We evaluated possible associations between OH and mortality in a retrospective study of frail elderly patients who came for a comprehensive geriatric assessment. ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000000977
更新日期:2015-06-01 00:00:00
abstract::To characterize the current frequency of HIV-1 coreceptor usage in China and assess the candidacy of CCR5 antagonists for treatment of HIV infections. In addition, we aimed to evaluate the potential of X4/DM virus transmission in recently infected men who have sex with men (MSM) individuals.Viral tropism testing was p...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005017
更新日期:2016-09-01 00:00:00
abstract::Irreversible electroporation (IRE) is a new nonthermal tumor ablation modality that induces apoptosis in the treated tissue without affecting collagen. Its use is particularly indicated for tumors involving major structures, such as encompassed or infiltrated vessels and/or ducts, which need to be preserved and hinder...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000000946
更新日期:2015-07-01 00:00:00
abstract:RATIONALE:Advanced ovarian malignancies are associated with poor overall survival; thus, patients often turn to alternative treatments, despite the controversy surrounding their use. Mistletoe extract has been commonly used as complementary medicine to treat patients with cancer for several decades, and has proven bene...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000014536
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Mycoplasma pneumoniae (MP) infection in infants is usually overlooked and it might result in important complications if left untreated. MP-induced arthritis is probably the least common extrapulmonary manifestation and frequently leads to delays in the diagnosis. PATIENT CONCERNS:We report the case of a 2...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000024316
更新日期:2021-01-15 00:00:00
abstract:INTRODUCTION:Fecal microbiota transplantation (FMT) is currently being explored as a potential therapy for ulcerative colitis (UC). Here, we report the first case of a UC patient with allergy to 5-aminosalicylic acid (5-ASA) who underwent FMT and achieved clinical remission. CASE PRESENTATION:This patient had a 9-year...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000010675
更新日期:2018-05-01 00:00:00
abstract::We conducted the present study to determine whether subclinical macrovascular atherosclerotic disease was present in patients with ankylosing spondylitis (AS) without clinical history of cardiovascular disease. We also sought to establish whether demographic or clinical features of the disease may influence the develo...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0b013e3181c10773
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:Prolotherapy or proliferative therapy is a treatment option for damaged connective tissues involving the injection of a solution (proliferant) which theoretically causes an initial cell injury and a subsequent "proliferant" process of wound healing via modulation of the inflammatory process. Nonetheless, the...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000023201
更新日期:2020-11-13 00:00:00
abstract:BACKGROUND:The aim of this article is to assess the influence of comorbidities among elderly patients (at least 70 year old) undergoing surgery for early stage nonsmall cell lung cancer (NSCLC) and to explore the tolerability and efficacy of surgery in relation to stereotactic body radiotherapy (SBRT) in this patient p...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000005212
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Prostaglandin E1 (P) or methylcobalamin (M) treatment has been suggested as a therapeutic approach for diabetic peripheral neuropathy (DPN) in many clinical trial reports. However, the combined effects of 2 drugs still remain dubious. OBJECTIVE:The aim of this report was to evaluate the efficacy of M plus P...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000013020
更新日期:2018-11-01 00:00:00
abstract::The long-term survival of end-stage renal disease (ESRD) patients with hepatitis C virus (HCV) infection who received interferon treatment has not been extensively evaluated.The HCV cohort was the ESRD patients with de novo HCV infection from 2004 to 2011; they were classified into treated and untreated groups accordi...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000002113
更新日期:2015-11-01 00:00:00
abstract::Lateral neck radiography is often used as a screening tool in emergency departments for suspected acute epiglottitis. The qualitative radiographic signs have been mainly used. The aim of this study was to evaluate the accuracy of objective radiographic parameters to aid diagnosis of acute epiglottitis.Patients who wer...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000012256
更新日期:2018-09-01 00:00:00
abstract::[This corrects the article DOI: 10.1097/MD.0000000000002223.]. ...
journal_title:Medicine
pub_type: 已发布勘误
doi:10.1097/MD.0000000000007997
更新日期:2017-09-01 00:00:00
abstract:RATIONALE:Intraspinal tophaceous gout is relatively rare condition presenting with major clinical manifestations, such as spinal cord or nerve roots compressions (radiculopathy). It is usually difficult to differentiate intraspinal tophaceous gout, lumbar disc herniation, stenosis of spinal canal, ossification of ligam...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000020125
更新日期:2020-05-22 00:00:00
abstract::Extra-cardiac abdominal complications are common in left-side infective endocarditis (LS-IE). The aim of this work was to study whether patients with LS-IE presenting splenic, renal, or liver (SRL) involvement seen in abdominal computed tomography (CT) had different clinical features, therapeutic plans, and outcome th...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000011952
更新日期:2018-08-01 00:00:00
abstract::Cryptococcal meningiti s causes 15% of AIDS-related deaths globally. Screening and preemptive treatment for cryptococcal antigen (CrAg) in the blood of persons with advanced HIV/AIDS reduces mortality. National and international HIV guidelines recommend CrAg screening; however, implementation studies and evaluations o...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000011722
更新日期:2018-08-01 00:00:00
abstract:RATIONALE:Tracheobronchial injury from acid ingestion is a less reported clinical presentation than injury of the gastrointestinal tract, but it can occur due to direct exposure from acid aspiration and cause fatal complications. PATIENT CONCERNS:A 43-year-old man presented to the emergency department after ingesting ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000023586
更新日期:2020-12-11 00:00:00
abstract::Little is known about the effect of nonsteroidal anti-inflammatory drugs (NSAIDs), thiazolidinediones (TZDs), nifedipine and nondihydropyridine calcium channel blockers (CCBs) usage on the risk of all-cause hospitalization among seniors with heart failure (HF). We assessed the risk of all-cause hospitalization associa...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000006239
更新日期:2017-03-01 00:00:00
abstract::Little is known regarding alterations of the renin-angiotensin system in patients referred for cardiac catheterization. Here, we measured plasma levels of active renin and aldosterone in patients referred for cardiac catheterization in order to determine the prevalence of elevated renin, aldosterone, and the aldostero...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000007282
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:To explore the safety and efficacy of several special approaches of drainage for deep inaccessible intraabdominal and pelvic abscesses. METHODS:By searching of our institutional database, the clinical and radiologic information of all patients with special approaches of abscesses drainage was collected, con...
journal_title:Medicine
pub_type: 杂志文章,评审
doi:10.1097/MD.0000000000012905
更新日期:2018-10-01 00:00:00
abstract:RATIONALE:The fundamental pathogenesis of Behçet disease (BD) is still unclear and controversial. Many cases of oral aphthous ulcers and genital ulcers related to BD are reported; nevertheless, idiopathic giant esophageal ulcers related to BD are rare. A rare case for esophageal ulcers related to BD is presented. PATI...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000008469
更新日期:2017-11-01 00:00:00
abstract::Identification of secondary colonic neoplasia proximal to obstructing colorectal cancer is essential for determining the range of colorectal resection.We examined the accuracy of 18-fluoro deoxy glucose-positron emission tomography (FDG-PET) for detection of colonic neoplasia.We recruited patients with obstructing col...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000011655
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:This protocol for a systematic review describes the methods that will be used to evaluate the efficacy and safety of non-pharmacological interventions for patients with dementia. METHODS:We will search ALOIS, the specialized register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), without ...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000017279
更新日期:2019-09-01 00:00:00
abstract::Previous studies have reported that intraoperative dexmedetomidine has morphine-sparing effects in patient-controlled analgesia (PCA). The present study was designed to investigate the possible sex differences in the morphine-sparing effects of intraoperative dexmedetomidine following general anesthesia. A total of 22...
journal_title:Medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/MD.0000000000003619
更新日期:2016-05-01 00:00:00
abstract::To compare imaging indicators and clinical effects of extreme lateral interbody fusion (XLIF) using allogenic bone, autologous bone marrow + allogenic bone, and rhBMP-2 + allogenic bone as bone graft materials in the treatment of degenerative lumbar diseases.This was a retrospective study of 93 patients with lumbar in...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000017685
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To explore the effect of ginkgo biloba extract (EGb) as an adjunctive treatment of elderly patients with depression and the effect on the expression of serum S100B. METHODS:136 elderly patients with depression were divided into EGb + citalopram (Cit) group and Cit group equally. Efficacy was evaluated by Ha...
journal_title:Medicine
pub_type: 临床试验,杂志文章
doi:10.1097/MD.0000000000012421
更新日期:2018-09-01 00:00:00
abstract::A significant rise in the prevalence of type 2 diabetes mellitus (T2DM) in the Middle-east and North Africa (MENA) region has seen over the last few decades. The present observational study aimed to evaluate and compare the risk of developing T2DM in the cities of Riyadh and Amman using the Arab Diabetes Risk Assessme...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000012689
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:To synthesize and evaluate the impact of implementing post-2010 World Health Organization (WHO) prevention of mother-to-child transmission (PMTCT) guidelines on attainment of PMTCT targets. METHODS:Retrospective and prospective cohort study designs that utilized routinely collected data with a focus on prov...
journal_title:Medicine
pub_type: 杂志文章,评审
doi:10.1097/MD.0000000000008055
更新日期:2017-10-01 00:00:00
abstract::Thrombosis are severe complications of paroxysmal nocturnal hemoglobinuria (PNH), effectively reduced by eculizumab. Extracellular vesicles (EVs) may play a central role. The objective of this study was to assess the procoagulant activity of plasma isolated from PNH patients (treated or not by eculizumab) and to quant...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000016164
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:As a novel ultrasound technique, superb microvascular imaging can quickly, simply and noninvasively study the microvascular distribution in the tumor and evaluate the microvascular perfusion. Studies suggested that superb microvascular imaging is helpful for the differentiation between benign and malignant l...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000022034
更新日期:2020-09-04 00:00:00