Evidence map›Paper›PMID 29974388›Full record

Observational studyInfection2018

Diabetes was the only comorbid condition associated with mortality of invasive pneumococcal infection in ICU patients: a multicenter observational study from the Outcomerea research group.

Maité Garrouste-Orgeas, Elie Azoulay, Stéphane Ruckly, Carole Schwebel, Etienne de Montmollin, Jean-Pierre Bedos, Bertrand Souweine, Guillaume Marcotte, Christophe Adrie, Dany Goldgran-Toledano and 7 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Mortality and costs of pneumococcal pneumonia in adults: a cross-sectional study.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 11 institutions in 1 country.

Maité Garrouste-OrgeasUMR 1137, IAME Team 5, DeSCID: Decision Sciences in Infectious Diseases, Control and Care, Sorbonne Paris Cité, Inserm/Paris Diderot University, Paris, France. Maite.garrouste@ihfb.org.
Elie AzoulayMedical Intensive Care Unit, Saint Louis University Hospital, Paris, France.
Stéphane RucklyOutcomerea Research Group, Paris, France.
Carole SchwebelMedical Intensive Care Unit, Albert Michallon Hospital, Grenoble, France.
Etienne de MontmollinMedical-Surgical Intensive Care Unit, Delafontaine Hospital, Saint-Denis, France.
Jean-Pierre BedosMedical Intensive Care Unit, André Mignot Hospital, Le Chesnay, France.
Bertrand SouweineMedical Intensive Care Unit, Gabriel Montpied University Hospital, Clermont-Ferrand, France.
Guillaume MarcotteSurgical ICU, Edouard Herriot University Hospital, Lyon, France.
Christophe AdriePhysiology department, Cochin University Hospital, Paris Descartes University, Paris, France.
Dany Goldgran-ToledanoMedical-Surgical Intensive Care Unit, Montfermeil, France.
Anne-Sylvie DumenilMedical Intensive Care Unit, Antoine Béclère Hospital, Clamart, France.
Hatem KallelMedical-Surgical Unit, Andrée Rosemon Hospital, Cayenne, Guyane, France.
Samir JamaliMedical-Surgical Unit, Sud-Essonne Hospital, Dourdan, France.
Laurent ArgaudMedical Intensive Care Unit, Edouard Herriot University Hospital, Lyon, France.
Michael DarmonMedical Intensive Care Unit, Saint Etienne University Hospital, Saint-Étienne, France.
Jean-Ralph ZaharInfection Control Unit, Avicenne University Hospital, Bobigny, France.
J F TimsitUMR 1137, IAME Team 5, DeSCID: Decision Sciences in Infectious Diseases, Control and Care, Sorbonne Paris Cité, Inserm/Paris Diderot University, Paris, France.
Hospices Civils de Lyon · FRUniversité Paris Cité · FRCentre Hospitalier Saint-Denis · FRCentre Hospitalier Sud-Essonne Dourdan-Etampes · FRGroupe Hospitalier Intercommunal Le Raincy Montfermeil · FRHôpital Albert Michallon · FRHôpital André Mignot · FRHôpital Antoine-Béclère · FRInserm · FRUniversité Jean Monnet · FRUniversité Sorbonne Paris Nord · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposesStreptococcus pneumoniae is a leading pathogen of severe community, hospital or nursing facility infections. We sought to describe characteristics of invasive pneumococcal infection (IPI) and pneumonia (due to the high mortality of intensive care-associated pneumonia) and to report outcomes according to various types of comorbidity.

methodsMulticenter observational cohort study on the prospective Outcomerea database, including adult patients, with a hospital stay < 48 h before ICU admission and a documented IPI within the first 72 h of ICU admission. Comorbid conditions were defined according to the Knaus and Charlson classification.

resultsOf the 20,235 patients, 5310 (26.4%) had an invasive infection, including 560/5,310 (10.6%) who had an IPI. The ICU 28-day mortality was 109/560 (19.8%). Four factors were independently associated with mortality: SOFA day 1-2: [hazard ratio (HR) 1.21; 95% confidence interval (95% CI) 1.15-1.27, p < 0.001]; maximum lactate level day 1-2: (HR 1.07, 95% CI 1.02-1.12, p = 0.006); diabetes mellitus: (HR 1.91, 95% CI 1.23-3.03, p = 0.006) and appropriate antibiotics (HR 0.28, 95% CI 0.15-0.50, p < 0.001). Comparable results were obtained when other comorbid conditions were forced into the model. Diabetes impact was more pronounced in case of micro- or macro-angiopathy (HR 4.17, 95%CI 1.68-10.54, p = 0.003), in patients ≥ 65 years old (HR 2.59, 95% CI 1.56-4.28, < 0.001) and in those with body mass index (BMI) < 25 kg/m

conclusionsDiabetes mellitus was the only comorbid condition which independently influenced mortality in patients with IPI. Its impact was more pronounced in patients with complications, aged ≥ 65 years and with BMI < 25 kg/m

Indexed as

Hospital MortalityIntensive Care UnitsAgedComorbidityCritical CareDiabetes MellitusFemaleFranceHumansMaleMiddle AgedPneumococcal InfectionsProportional Hazards ModelsPublic Health SurveillanceRisk FactorsStreptococcus pneumoniaeCritical careDiabetes mellitusIntensive care unitInvasive pneumococcal infection

Identifiers

PMID29974388
OpenAlexW2810588387

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.