Observational studyBMC infectious diseases2020
Modifiable healthcare factors affecting 28-day survival in bloodstream infection: a prospective cohort study.
Observational study in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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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.
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Who cites it
10 citing papers in PubMed.
- Emulating the MERINO randomised control trial using data from an observational cohort and trial of rapid diagnostic (BSI-FOO).PloS one · 2022Trial
- Trial
- Construction and validation of a predictive model for mortality risk in patients with Staphylococcus aureus bloodstream infection.BMC infectious diseases · 2026Article
- Clinical significance of inflammatory markers for evaluating disease severity of mixed-pathogen bloodstream infections of bothHeliyon · 2024Article
- The relationship between minimum inhibitory concentration and 28 day mortality in patients with a Gram-negative bloodstream infection: an analysis of data from a cohort study (BSI-FOO).JAC-antimicrobial resistance · 2023Article
- The effect of duration of therapy for treatment of Staphylococcus aureus blood stream infection: an application of cloning to deal with immortal-time bias in an analysis of data from a cohort study (BSI-FOO).The Journal of antimicrobial chemotherapy · 2022Article
- Bacterial genotypic and patient risk factors for adverse outcomes in Escherichia coli bloodstream infections: a prospective molecular epidemiological study.The Journal of antimicrobial chemotherapy · 2022Article
- Blood bacterial resistant investigation collaborative system (BRICS) report: a national surveillance in China from 2014 to 2019.Antimicrobial resistance and infection control · 2022Article
- Analytical challenges in estimating the effect of exposures that are bounded by follow-up time: experiences from the Blood Stream Infection-Focus on Outcomes study.BMC medical research methodology · 2021Article
- Observational
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundBloodstream infection is common in the UK and has significant mortality depending on the pathogen involved, site of infection and other patient factors. Healthcare staffing and ward activity may also impact on outcomes in a range of conditions, however there is little specific National Health Service (NHS) data on the impact for patients with bloodstream infection. Bloodstream Infections - Focus on Outcomes is a multicentre cohort study with the primary aim of identifying modifiable risk factors for 28-day mortality in patients with bloodstream infection due to one of six key pathogens.
methodsAdults under the care of five NHS Trusts in England and Wales between November 2010 and May 2012 were included. Multivariable Cox regression was used to quantify the association between modifiable risk factors, including staffing levels and timing of appropriate therapy, and 28-day mortality, after adjusting for non-modifiable risk factors such as patient demographics and long-term comorbidities.
resultsA total of 1676 patients were included in the analysis population. Overall, 348/1676 (20.8%) died within 28 days. Modifiable factors associated with 28-day mortality were ward speciality, ward activity (admissions and discharges), movement within ward speciality, movement from critical care, and time to receipt of appropriate antimicrobial therapy in the first 7 days. For each additional admission or discharge per 10 beds, the hazard increased by 4% (95% CI 1 to 6%) in medical wards and 11% (95% CI 4 to 19%) in critical care. Patients who had moved wards within speciality or who had moved out of a critical care ward had a reduction in hazard of mortality. In the first 7 days, hazard of death increased with increasing time to receipt of appropriate antimicrobial therapy.
conclusionThis study underlines the importance of appropriate antimicrobials within the first 7 days, and the potential for ward activity and ward movements to impact on survival in bloodstream infection.
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