Risk factors for poor outcomes in children with candidemia

Doctoral Dissertation uoadl:1308558 414 Read counter

Unit:
Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences
Deposit date:
2014-07-15
Year:
2014
Author:
Ζαούτης Θεοκλής
Dissertation committee:
καθηγητής Χρούσος Γεώγιος
Original Title:
Risk factors for poor outcomes in children with candidemia
Languages:
English
Translated title:
Παράγοντες κινδύνου για την δυσμενή έκβαση παιδιών με καντινταιμία
Summary:
Candida species are the leading cause of invasive fungal infections in
hospitalized children. Invasive candidiasis is associated with significant
morbidity, mortality and healthcare costs. The objective of this study was to
identify factors associated with poor outcomes in children with candidemia and
specifically to investigate the impact of early Central Venous Catheter CVC
removal and species of Candida on 30-day mortality. This is a retrospective
cohort study of all pediatric (age 0 to <19 years) patients with candidemia
during admission at the Children’s Hospital of Philadelphia between 1997 and
2009. There were 405 incident episodes of candidemia with an associated 30-day
mortality rate of 12.3%. In a multivariate logistic model only intensive care
unit admission and presence of an arterial line were independently associated
with inpatient mortality. In the multivariate discrete time-failure model,
retention of the CVC was not associated with an increased risk for 30-day
inpatient mortality (aOR: 1.65; 95% CI: 0.63, 4.32). The infecting species of
candida was not associated with mortality. In conclusion, pediatric mortality
in the setting of candidemia continues to be substantial and is associated with
markers of severe illness. In this retrospective cohort, early removal of the
CVC and species did not result in a reduced risk for death.
Keywords:
Risk factors, Children, Candidemia
Index:
Yes
Number of index pages:
11
Contains images:
Yes
Number of references:
130
Number of pages:
111

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