Evidence map›Paper›PMID 38869773›Full record

ArticleInfection2024

Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study.

Ili Margalit, Dafna Yahav, Tomer Hoffman, Alexis Tabah, Stéphane Ruckly, François Barbier, Pierre Singer, Jean-François Timsit, Virginie Prendki, Niccolò Buetti and 1 more

Erratum issuedAbstract readMulticenter StudyComparative Study
In one paragraph

Article in Infection, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Ili MargalitInfectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel. ilimargalit@gmail.com.
Dafna YahavInfectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel.
Tomer HoffmanInfectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel.
Alexis TabahIntensive Care Unit, Redclife Hospital, Brisbane, QLD, Australia.
Stéphane RucklyIAME UMR 1137, INSERM, Université de Paris, 75018, Paris, France.
François BarbierService de Médecine Intensive‑Réanimation, Centre Hospitalier Régional d'Orléans, 14, Avenue de L'Hôpital, 45100, Orléans, France.
Pierre SingerFaculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Jean-François TimsitIAME UMR 1137, INSERM, Université de Paris, 75018, Paris, France.
Virginie Prendki *Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
Niccolò Buetti *IAME UMR 1137, INSERM, Université de Paris, 75018, Paris, France.
EUROBACT-2 Study Group, the European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP) and Infections in the Elderly (ESGIE), and the OUTCOMEREA Network

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOlder adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI).

methodsNested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021. We compared older versus younger adults in terms of infection characteristics (clinical signs and symptoms, source, and microbiological data), management (imaging, source control, antimicrobial therapy), and outcomes (28-day mortality and hospital discharge).

resultsAmong 2111 individuals hospitalized in 219 ICUs with HA-BSI, 563 (27%) were ≥ 75 years old. Compared to younger patients, these individuals had higher comorbidity score and lower functional capacity; presented more often with a pulmonary, urinary, or unknown HA-BSI source; and had lower heart rate, blood pressure and temperature at presentation. Pathogens and resistance rates were similar in both groups. Differences in management included mainly lower rates of effective source control achievement among aged individuals. Older adults also had significantly higher day-28 mortality (50% versus 34%, p < 0.001), and lower rates of discharge from hospital (12% versus 20%, p < 0.001) by this time.

conclusionsOlder adults with HA-BSI hospitalized in ICU have different baseline characteristics and source of infection compared to younger patients. Management of older adults differs mainly by lower probability to achieve source control. This should be targeted to improve outcomes among older ICU patients.

Indexed as

Cross InfectionIntensive Care UnitsAdultAgedAged, 80 and overAge FactorsBacteremiaCohort StudiesFemaleHumansMaleMiddle AgedProspective StudiesSepsisTreatment OutcomeBacteremiaElderlyICUMortalityNosocomial Infections

Identifiers

PMID38869773
PMCPMC11621140

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Registered trials

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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.