Candida Infections in Critically Ill Trauma Patients: A Retrospective Case-Control Study
HYPOTHESIS We sought to determine whether the usual risk factors for fungal infections are applied to trauma patients. DESIGN Case-control study. SETTING American College of Surgeons Committee on Trauma–certified Level I trauma center in a tertiary care community hospital. PATIENTS Screening of medi...
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| Veröffentlicht in: | Archives of surgery (Chicago. 1960) 1999-06, Vol.134 (6), p.657-665 |
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| container_title | Archives of surgery (Chicago. 1960) |
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| creator | Borzotta, Anthony P Beardsley, Kathleen |
| description | HYPOTHESIS We sought to determine whether the usual risk factors for fungal infections are applied to trauma patients. DESIGN Case-control study. SETTING American College of Surgeons Committee on Trauma–certified Level I trauma center in a tertiary care community hospital. PATIENTS Screening of medical records of a consecutive sample of 459 patients aged 16 years or older admitted to an intensive care unit for 4 days or more from 1993 through 1996 identified 20 patients infected with Candida species. Two case controls for each were selected from the remaining patients using sex, age within 5 years, mechanism of injury, and best fit of first 4 Abbreviated Injury Scale scores; the Injury Severity Score and intensive care unit length of stay were also used if needed. INTERVENTIONS None. RESULTS Univariate analyses by t and χ2 tests showed significance (P |
| doi_str_mv | 10.1001/archsurg.134.6.657 |
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DESIGN Case-control study. SETTING American College of Surgeons Committee on Trauma–certified Level I trauma center in a tertiary care community hospital. PATIENTS Screening of medical records of a consecutive sample of 459 patients aged 16 years or older admitted to an intensive care unit for 4 days or more from 1993 through 1996 identified 20 patients infected with Candida species. Two case controls for each were selected from the remaining patients using sex, age within 5 years, mechanism of injury, and best fit of first 4 Abbreviated Injury Scale scores; the Injury Severity Score and intensive care unit length of stay were also used if needed. INTERVENTIONS None. RESULTS Univariate analyses by t and χ2 tests showed significance (P<.05) for number of units of blood transfused in the first 24 hours after injury, gastrointestinal perforation, hemodialysis, and total parenteral nutrition. Steroids, fungal colonization, use of central venous catheters, Acute Physiology and Chronic Health Evaluation II score, mechanical ventilation for 3 days or more, and the number and duration of antibiotics were not significantly different. Logistic regression analysis showed that only total parenteral nutrition was an independent risk factor in this trauma population. CONCLUSION Many of the classic risk factors for fungal infection in other populations are actually concomitants of injury severity and its requisite level of care in trauma patients. Hyperalimentation in persistently critically ill trauma patients significantly increases the risk of Candida infection.Arch Surg. 1999;134:657-665--></description><identifier>ISSN: 0004-0010</identifier><identifier>ISSN: 2168-6254</identifier><identifier>EISSN: 1538-3644</identifier><identifier>EISSN: 2168-6262</identifier><identifier>DOI: 10.1001/archsurg.134.6.657</identifier><identifier>PMID: 10367877</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Adult ; Candidiasis - complications ; Candidiasis - epidemiology ; Case-Control Studies ; Critical Illness ; Female ; Humans ; Male ; Nursing ; Retrospective Studies ; Risk Factors ; Wounds and Injuries - complications ; Wounds and Injuries - microbiology</subject><ispartof>Archives of surgery (Chicago. 1960), 1999-06, Vol.134 (6), p.657-665</ispartof><rights>Copyright American Medical Association Jun 1999</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamasurgery/articlepdf/10.1001/archsurg.134.6.657$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.134.6.657$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3338,27923,27924,76260,76263</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10367877$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Borzotta, Anthony P</creatorcontrib><creatorcontrib>Beardsley, Kathleen</creatorcontrib><title>Candida Infections in Critically Ill Trauma Patients: A Retrospective Case-Control Study</title><title>Archives of surgery (Chicago. 1960)</title><addtitle>Arch Surg</addtitle><description>HYPOTHESIS We sought to determine whether the usual risk factors for fungal infections are applied to trauma patients. DESIGN Case-control study. SETTING American College of Surgeons Committee on Trauma–certified Level I trauma center in a tertiary care community hospital. PATIENTS Screening of medical records of a consecutive sample of 459 patients aged 16 years or older admitted to an intensive care unit for 4 days or more from 1993 through 1996 identified 20 patients infected with Candida species. Two case controls for each were selected from the remaining patients using sex, age within 5 years, mechanism of injury, and best fit of first 4 Abbreviated Injury Scale scores; the Injury Severity Score and intensive care unit length of stay were also used if needed. INTERVENTIONS None. RESULTS Univariate analyses by t and χ2 tests showed significance (P<.05) for number of units of blood transfused in the first 24 hours after injury, gastrointestinal perforation, hemodialysis, and total parenteral nutrition. Steroids, fungal colonization, use of central venous catheters, Acute Physiology and Chronic Health Evaluation II score, mechanical ventilation for 3 days or more, and the number and duration of antibiotics were not significantly different. Logistic regression analysis showed that only total parenteral nutrition was an independent risk factor in this trauma population. CONCLUSION Many of the classic risk factors for fungal infection in other populations are actually concomitants of injury severity and its requisite level of care in trauma patients. Hyperalimentation in persistently critically ill trauma patients significantly increases the risk of Candida infection.Arch Surg. 1999;134:657-665--></description><subject>Adult</subject><subject>Candidiasis - complications</subject><subject>Candidiasis - epidemiology</subject><subject>Case-Control Studies</subject><subject>Critical Illness</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Nursing</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Wounds and Injuries - complications</subject><subject>Wounds and Injuries - microbiology</subject><issn>0004-0010</issn><issn>2168-6254</issn><issn>1538-3644</issn><issn>2168-6262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkMtKxDAUhoMozjj6ALqQ4MJda25NU3dD8TIwoOgI7kKapFrpZUxaYd7eDB1FXOWQ8_2Hcz4AzjCKMUL4Sjn97gf3FmPKYh7zJN0DU5xQEVHO2D6YIoRYFEg0AUfef4SKiIwcgglGlKciTafgNVetqYyCi7a0uq-61sOqhbmr-kqrut7ARV3DlVNDo-Cj6ivb9v4azuGT7V3n19vMl4W58jbKuzb81fC5H8zmGByUqvb2ZPfOwMvtzSq_j5YPd4t8vowUyZI-4ik3Ni0xz0giBCsENcywDHOdMUZSXSBkTckLRmiCDdMlTUouTLhPGyGQojNwOc5du-5zsL6XTeW1rWvV2m7wkmcCCy6yAF78Az-6wbVhN0koSRKGRRogMkI6HOedLeXaVY1yG4mR3EqXP9JlkC65DNJD6Hw3eSgaa_5ERssBOB0B1ajfLs0QxZR-A28chrA</recordid><startdate>19990601</startdate><enddate>19990601</enddate><creator>Borzotta, Anthony P</creator><creator>Beardsley, Kathleen</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>19990601</creationdate><title>Candida Infections in Critically Ill Trauma Patients: A Retrospective Case-Control Study</title><author>Borzotta, Anthony P ; Beardsley, Kathleen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a295t-676de7f16925884b83d4d4916c94427cb00edf6b42351d4cf35f68d644cd880a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Candidiasis - complications</topic><topic>Candidiasis - epidemiology</topic><topic>Case-Control Studies</topic><topic>Critical Illness</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Nursing</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Wounds and Injuries - complications</topic><topic>Wounds and Injuries - microbiology</topic><toplevel>online_resources</toplevel><creatorcontrib>Borzotta, Anthony P</creatorcontrib><creatorcontrib>Beardsley, Kathleen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of surgery (Chicago. 1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Borzotta, Anthony P</au><au>Beardsley, Kathleen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Candida Infections in Critically Ill Trauma Patients: A Retrospective Case-Control Study</atitle><jtitle>Archives of surgery (Chicago. 1960)</jtitle><addtitle>Arch Surg</addtitle><date>1999-06-01</date><risdate>1999</risdate><volume>134</volume><issue>6</issue><spage>657</spage><epage>665</epage><pages>657-665</pages><issn>0004-0010</issn><issn>2168-6254</issn><eissn>1538-3644</eissn><eissn>2168-6262</eissn><abstract>HYPOTHESIS We sought to determine whether the usual risk factors for fungal infections are applied to trauma patients. DESIGN Case-control study. SETTING American College of Surgeons Committee on Trauma–certified Level I trauma center in a tertiary care community hospital. PATIENTS Screening of medical records of a consecutive sample of 459 patients aged 16 years or older admitted to an intensive care unit for 4 days or more from 1993 through 1996 identified 20 patients infected with Candida species. Two case controls for each were selected from the remaining patients using sex, age within 5 years, mechanism of injury, and best fit of first 4 Abbreviated Injury Scale scores; the Injury Severity Score and intensive care unit length of stay were also used if needed. INTERVENTIONS None. RESULTS Univariate analyses by t and χ2 tests showed significance (P<.05) for number of units of blood transfused in the first 24 hours after injury, gastrointestinal perforation, hemodialysis, and total parenteral nutrition. Steroids, fungal colonization, use of central venous catheters, Acute Physiology and Chronic Health Evaluation II score, mechanical ventilation for 3 days or more, and the number and duration of antibiotics were not significantly different. Logistic regression analysis showed that only total parenteral nutrition was an independent risk factor in this trauma population. CONCLUSION Many of the classic risk factors for fungal infection in other populations are actually concomitants of injury severity and its requisite level of care in trauma patients. Hyperalimentation in persistently critically ill trauma patients significantly increases the risk of Candida infection.Arch Surg. 1999;134:657-665--></abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>10367877</pmid><doi>10.1001/archsurg.134.6.657</doi><tpages>9</tpages></addata></record> |
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| ispartof | Archives of surgery (Chicago. 1960), 1999-06, Vol.134 (6), p.657-665 |
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| subjects | Adult Candidiasis - complications Candidiasis - epidemiology Case-Control Studies Critical Illness Female Humans Male Nursing Retrospective Studies Risk Factors Wounds and Injuries - complications Wounds and Injuries - microbiology |
| title | Candida Infections in Critically Ill Trauma Patients: A Retrospective Case-Control Study |
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