ArticleEpidemiology and infection2011
Influence of referral bias on the clinical characteristics of patients with Gram-negative bloodstream infection.
Article in Epidemiology and infection, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- Observational
- Article
- Population-based study ofJournal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2023Article
- Pasteurella species bloodstream infections in Queensland, Australia, 2000-2019.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Combining primary cohort data with external aggregate information without assuming comparability.Biometrics · 2021Article
- Burden of bloodstream infection in older persons: a population-based study.BMC geriatrics · 2021Article
- Therapeutic Alliance in Cognitive Behavioural Therapy in Child and Adolescent Mental Health-Current Trends and Future Challenges.Frontiers in psychology · 2021Article
- Increasing relevance of Gram-positive cocci in urinary tract infections: a 10-year analysis of their prevalence and resistance trends.Scientific reports · 2020Article
- Population-based risk factors for community-onset bloodstream infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot.Antibiotics (Basel, Switzerland) · 2019Article
- Direct Measurement of Performance: A New Era in Antimicrobial Stewardship.Antibiotics (Basel, Switzerland) · 2019Review
- Epidemiological Trends and Resistance Associated withDiseases (Basel, Switzerland) · 2019Article
- Outcome and undertreatment of mitral regurgitation: a community cohort study.Lancet (London, England) · 2018Observational
- Epidemiology of Infective Endocarditis in Rural Upstate New York, 2011 - 2016.Journal of clinical medicine research · 2017Article
- Impact of healthcare-associated acquisition on community-onset Gram-negative bloodstream infection: a population-based study: healthcare-associated Gram-negative BSI.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2012Article
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3 authors.
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Abstract
Referral bias can influence the results of studies performed at tertiary-care centres. In this study, we evaluated demographic and microbiological factors that influenced referral of patients with Gram-negative bloodstream infection (BSI). We identified 2919 and 846 unique patients with Gram-negative BSI in a referral cohort of patients treated at Mayo Clinic Hospitals and a population-based cohort of Olmsted County, Minnesota, residents between 1 January 1998 and 31 December 2007, respectively. Multivariable logistic regression analysis was used to determine factors associated with referral. Elderly patients aged ≥80 years with Gram-negative BSI were less likely to be referred than younger patients [odds ratio (OR) 0·43, 95% confidence intervals (CI) 0·30-0·62] as were females (OR 0·63, 95% CI 0·53-0·74). After adjusting for age and gender, bloodstream isolates of Escherichia coli (OR 0·50, 95% CI 0·43-0·58) and Proteus mirabilis (OR 0·49, 95% CI 0·30-0·82) were underrepresented in the referral cohort; and Pseudomonas aeruginosa (OR 2·26, 95% CI 1·70-3·06), Enterobacter cloacae (OR 2·31, 95% CI 1·53-3·66), Serratia marcescens (OR 2·34, 95% CI 1·33-4·52) and Stenotrophomonas maltophilia (OR 17·94, 95% CI 3·98-314·43) were overrepresented in the referral cohort. We demonstrated that demographic and microbiological characteristics of patients with Gram-negative BSI had an influence on referral patterns. These factors should be considered when interpreting results of investigations performed at tertiary-care centres.
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