ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Positive Impact of [18F]FDG-PET/CT on Mortality in Patients With Staphylococcus aureus Bacteremia Explained by Immortal Time Bias.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 22 citations in OpenAlex.
- Quantifying Potential Immortal Time Bias in Observational Studies in Acute Severe Infection.Open forum infectious diseases · 2025Trial
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- Risk and Distribution of Metastatic Infections by Primary Infection Focus inOpen forum infectious diseases · 2025Article
- Detection of septic metastases in catheter-related Staphylococcus aureus bacteremia using 18BMC infectious diseases · 2025Article
- Vertebral osteomyelitis in patients with infective endocarditis: prevalence, risk factors and mortality.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Observational
- Clinical revenues of selective use of [18F]-FDG-PET/CT scanning in the management of Staphylococcus aureus bacteremia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Review
- Article
- The role of [18F]FDG-PET/CT in Staphylococcus aureus bacteremia: A clinical perspective.Npj imaging · 2024Review
- Low-Risk Staphylococcus aureus Bacteremia Patients Do Not Require Routine Diagnostic Imaging: A Multicenter, Retrospective, Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Contemporary Management of Staphylococcus aureus Bacteremia-Controversies in Clinical Practice.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Review
- Global Differences in the Management of Staphylococcus aureus Bacteremia: No International Standard of Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
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12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have suggested that in patients with Staphylococcus aureus bacteremia (SAB) [18F] fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) improves outcome. However, these studies often ignored possible immortal time bias.
methodsProspective multicenter cohort study in 2 university and 5 non-university hospitals, including all patients with SAB. [18F]FDG-PET/CT was performed on clinical indication as part of usual care. Primary outcome was 90-day all-cause mortality. Effect of [18F]FDG-PET/CT was modeled with a Cox proportional hazards model using [18F]FDG-PET/CT as a time-varying variable and corrected for confounders for mortality (age, Charlson score, positive follow-up cultures, septic shock, and endocarditis). Secondary outcome was 90-day infection-related mortality (assessed by adjudication committee) using the same analysis. In a subgroup-analysis, we determined the effect of [18F]FDG-PET/CT in patients with high risk of metastatic infection.
resultsOf 476 patients, 178 (37%) underwent [18F]FDG-PET/CT. Day-90 all-cause mortality was 31% (147 patients), and infection-related mortality was 17% (83 patients). The confounder adjusted hazard ratio (aHR) for all-cause mortality was 0.50 (95% confidence interval [CI]: .34-.74) in patients that underwent [18F]FDG-PET/CT. Adjustment for immortal time bias changed the aHR to 1.00 (95% CI .68-1.48). Likewise, after correction for immortal time bias, [18F]FDG-PET/CT had no effect on infection-related mortality (cause specific aHR 1.30 [95% CI .77-2.21]), on all-cause mortality in patients with high-risk SAB (aHR 1.07 (95% CI .63-1.83) or on infection-related mortality in high-risk SAB (aHR for 1.24 [95% CI .67-2.28]).
conclusionsAfter adjustment for immortal time bias [18F]FDG-PET/CT was not associated with day-90 all-cause or infection-related mortality in patients with SAB.
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