Risk Factors for Mortality of Bacteremia in Surin Hospital

Abstract

Bacteremia presented clinical manifestation as sepsis, severe sepsis or septic shock was the common problem and resulted in high mortality rate. The objectives of this study were to study the relationship between risk factors and mortality and to set up the guideline for treatment to decrease mortality rate in bacteremic patient. A retrospective analytical study was performed in 116 bacteremic patients in Surin hospital during 1st July 2006 to 30nd June 2007. Data was collected from patient' s medical records. The risk factors in this study were sex, age, underlying disease, community acquired or nosocomial infection, sepsis, severe sepsis, septic shock, site of infection, pior of antibiotic treatment, adequate or inadequate antibiotic treatment and organism of bacteria from hemoculture mortality. The data was analyzed by univariate analysis and multiple logistic regression analysis. The results of the study revealed that the risk factors associated with mortality of which were statistically significant were age more than 50 year (OR 3.91 95%CI 1.04-14.68, P < 0.044) septic shock (OR 28.14 95%CI 6.12-102.57, P < 0.004) pior antibiotic treatment (OR 6.07 95%CI 1.88-19.62, P < 0.002) and inadequate antibiotic treatment (OR 37.75 95%CI 9.36-152.17, P < 0.001). Therefore the guideline for treatment to decrease mortality rate of bacteremic patient in Surin hospital were adequate antibiotic treatment, early empirical appropriate antibiotic treatment and antibiotic guideline and early gold directed therapy.