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Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

Overview of attention for article published in Critical Care, June 2012
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Title
Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis
Published in
Critical Care, June 2012
DOI 10.1186/cc11388
Pubmed ID
Authors

Francisco J González de Molina, Cristóbal León, Sergio Ruiz-Santana, Pedro Saavedra, the CAVA I Study Group

Abstract

ABSTRACT: INTRODUCTION: Candidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis. METHODS: A prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%. RESULTS: Thirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively. CONCLUSIONS: ICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 2%
France 1 1%
Spain 1 1%
Unknown 81 95%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 14%
Student > Master 10 12%
Student > Ph. D. Student 9 11%
Professor > Associate Professor 7 8%
Student > Doctoral Student 7 8%
Other 23 27%
Unknown 17 20%
Readers by discipline Count As %
Medicine and Dentistry 42 49%
Nursing and Health Professions 5 6%
Agricultural and Biological Sciences 5 6%
Immunology and Microbiology 5 6%
Psychology 3 4%
Other 5 6%
Unknown 20 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 June 2012.
All research outputs
#20,656,820
of 25,374,647 outputs
Outputs from Critical Care
#5,970
of 6,554 outputs
Outputs of similar age
#141,727
of 181,086 outputs
Outputs of similar age from Critical Care
#99
of 126 outputs
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