NDLI: Predisposing factors for candidemia in patients with major burns.

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Predisposing factors for candidemia in patients with major burns.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Fochtmann, Alexandra Forstner, Christina Hagmann, Michael Keck, Maike Muschitz, Gabriela Presterl, Elisabeth Ihra, Gerald Rath, Thomas
Description	Author Affiliation: Fochtmann A ( Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: alexandra.fochtmann@meduniwien.ac.at.); Forstner C ( Medical University of Vienna, Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Vienna, Austria. Electronic address: christina.a.forstner@meduniwien.ac.at.); Hagmann M ( Medical University of Vienna, Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna, Austria. Electronic address: michael.hagmann@meduniwien.ac.at.); Keck M ( Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: maike.keck@meduniwien.ac.at.); Muschitz G ( Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: gabriela.muschitz@meduniwien.ac.at.); Presterl E ( Medical University of Vienna, Clinical Institute of Infection Control and Hospital Epidemiology, Vienna, Austria. Electronic address: elisabeth.presterl@meduniwien.ac.at.); Ihra G ( Medical University of Vienna, Department of Anesthesiology and General Intensive Care, Vienna, Austria. Electronic address: gerald.ihra@meduniwien.ac.at.); Rath T ( Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: thomas.rath@meduniwien.ac.at.)
Abstract	BACKGROUND: Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns. METHODS: A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia. RESULTS: Twenty (11%) patients developed candidemia on median day 16 after ICU admission associated with an increased overall mortality (30% versus 10%). Statistical analysis identified the following factors associated with proven candidemia: younger age (years) odds ratio (OR):0.96, 95% confidence interval (95% CI):0.92-1.0, female gender (reference male) OR:5.03, 95% CI:1.25-24.9, gastrointestinal (GI) complications requiring surgery (reference no GI complication) OR:20.37, 95% CI:4.25-125.8, non-gastrointestinal thromboembolic complications (reference no thromboembolic complication) OR:17.3, 95% CI:2.57-170.4 and inhalation trauma (reference no inhalation trauma) OR:7.96, 95% CI:1.4-48.4. CONCLUSIONS: Above-mentioned patient groups are at considerably high risk for candidemia and might benefit from a prophylactic antifungal therapy. Younger age as associated risk factor is likely to be the result of the fact that older patients with a great extent of burn body surface have a lower chance of survival compared to younger patients with a comparable TBSA.
File Format	HTM / HTML
ISSN	03054179
Issue Number	2
Volume Number	41
e-ISSN	18791409
Journal	Burns
Language	English
Publisher	Elsevier
Publisher Date	2015-03-01
Publisher Place	Netherlands
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Traumatology Burns Complications Candidemia Etiology Adolescent Adult Age Factors Aged Aged, 80 And Over Antifungal Agents Therapeutic Use Drug Therapy Epidemiology Female Humans Incidence Intensive Care Units Statistics & Numerical Data Length Of Stay Logistic Models Male Middle Aged Odds Ratio Retrospective Studies Risk Factors Young Adult Journal Article
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Surgery Critical Care and Intensive Care Medicine

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