ISSN 1300-4948 | E-ISSN 2148-5607
Liver - Original Article
Bacteremia in cirrhotic patients with upper gastrointestinal bleeding
1 Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi County, Taiwan  
2 Department of Emergency, Taichung Tzu Chi Hospital, Taichung City, Taiwan  
3 Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua County, Taiwan  
4 Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi County, Taiwan.; Department of Nursing, Chang Gung University of Science and Technology, Chiayi County, Taiwan.  
Turk J Gastroenterol 2018; 29: 164-169
DOI: 10.5152/tjg.2018.17309
Key Words: Cirrhosis, upper gastrointestinal bleeding, antibiotics, bandemia, bacteremia, shock
Abstract

 

Background/Aims: Increased risk of bacterial infection is common in cirrhotic patients with upper gastrointestinal bleeding (UGIB). Our study aimed to explore the association of the bacteremia with in-hospital mortality and risk factors of bacteremia in these patients.

 

Materials and Methods: In our retrospective cohort study, we collected data for cirrhotic patients with UGIB admitted to our hospital between August 2010 and December 2010. The primary outcome was in-hospital mortality. The secondary outcome was bacteremia. A multivariate logistic regression analysis was performed to determine risk factors for mortality and bacteremia.

 

Results: A total of 202 patients with cirrhosis presenting with UGIB at the emergency department (ED) were enrolled. Bacteremia was associated with a higher mortality rate (adjusted odds ratio [OR]: 9.7; 95% confidence interval [CI]: 1.9-50.6, p=0.007), whereas shock (systolic blood pressure <90 mmHg at ED triage) and bandemia (>0% immature neutrophils of band form) were associated with bacteremia in cirrhotic patients with UGIB (adjusted OR: 5.3; 95% CI: 2.3-12.7, p<0.0001 and adjusted OR: 4.0; 95% CI: 1.6-9.9, p=0.0003, respectively).

 

Conclusion: Bacteremia in cirrhotic patients with UGIB is one of the major risk factors leading to in-hospital mortality. On the basis of our findings, prevention of bacteremia in cirrhotic patients with UGIB, especially in those with shock and bandemia, is important; thus, adequate antibiotic treatment is suggested.

 

 

 

Cite this article as: Shih HA, Tsai PC, Wu KH, Chen YT, Chen YC. Bacteremia in cirrhotic patients with upper gastrointestinal bleeding. Turk J Gastroenterol 2018; 29: 164-9.

 

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AVES | Copyright © 2018 Turkish Society of Gastroenterology | Latest Update: 21.05.2018