Risk factors of septic shock development and thirty-day mortality with a predictive model in adult candidemia patients in intensive care units.

Abstract

BACKGROUND:

This study aimed to investigate factors associated with septic shock development and 30-day mortality outcome with a prediction model among adult candidemia patients in the intensive care unit (ICU).

METHODS:

A retrospective study was conducted among patients admitted to the ICU from 2009 to 2018 at a tertiary care medical centre. The study subjects included adult patients ≥ 19 years with candidemia treated with antifungal agent for ≥ 3 days. Clinical variables were collected and analysed.

RESULTS:

A total of 126 patients were included in the study. Of these patients, 32 patients (25.4%) had septic shock. Multivariate logistic regression analysis revealed that chronic liver disease was associated with septic shock (odds ratio [OR] 3.372, 95% confidence interval [CI] 1.057 - 10.057). The rate of 30-day mortality was 35.7% and the associated mortality risk factors were malignancy (OR 8.251, 95% CI 2.227 - 30.573), chronic liver disease (OR 3.605, 95% CI 0.913 - 14.227), haemodialysis (OR 8.479, 95% CI 1.801 - 39.924), mycological failure (OR 29.675, 95% CI 7.012 - 125.578), and septic shock (OR 3.980, 95% CI 1.238 - 12.796). A predictive model for 30-day mortality was created based on the mortality risk factor scores, which had an area of 0.862 under the receiver operating characteristic curve.

CONCLUSIONS:

Adult candidemia patients in the ICU who have chronic liver disease may be at higher risk of developing septic shock. Furthermore, our predictive model for 30-day mortality based on the mortality risk factors may be useful for clinical assessment.

• Authors: Jin Woong Suh, Min Ja Kim, Jong Hun Kim
• Journal: Infectious diseases (London, England) (Infect Dis (Lond)) 2021 Nov-Dec Vol. 53 Issue 12 Pg. 908-919 ISSN: 2374-4243 [Electronic] England
• PMID: 34330205 (Publication Type: Journal Article)

Topics

• Adult
• Candidemia (epidemiology)
• Humans
• Intensive Care Units
• Prognosis
• Retrospective Studies
• Risk Factors
• Shock, Septic