Afebrile Bacteremia in Adult Emergency Department Patients with Liver Cirrhosis: Clinical Characteristics and Outcomes

Cirrhotic patients with bacteremia are at an increased risk of organ failure and mortality. In addition, they can develop serious infection without fever because of their impaired immune response. Our study aimed to investigate the clinical characteristics and outcomes in afebrile bacteremic patient...

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Bibliographic Details
Published in:Scientific reports 2020-05, Vol.10 (1), p.7617-7617, Article 7617
Main Authors: Chen, Hung-Yu, Hsu, Yin-Chou
Format: Article
Language:English
Subjects:
Antibiotics
Bacteremia
Bacteremia - complications
Bacteremia - diagnosis
Cirrhosis
Cohort Studies
Emergency medical care
Emergency Service, Hospital
Female
Fever
Humans
Immune response
Intubation
Liver
Liver cirrhosis
Liver Cirrhosis - complications
Male
Middle Aged
Mortality
Prognosis
Retrospective Studies
Risk factors
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Summary:Cirrhotic patients with bacteremia are at an increased risk of organ failure and mortality. In addition, they can develop serious infection without fever because of their impaired immune response. Our study aimed to investigate the clinical characteristics and outcomes in afebrile bacteremic patients with liver cirrhosis. A single-center, retrospective cohort study was performed on adult patients who visited the emergency department from January 2015 to December 2018. All patients with bacteremia and diagnosis of liver cirrhosis were enrolled and classified as either afebrile or febrile. In total, 104 bacteremic patients with liver cirrhosis (afebrile: 55 patients and, febrile: 49) were included in the study. Compared with the febrile group, patients in the afebrile group showed a significantly higher rate of inappropriate antibiotics administration (43.6% vs. 20.4%, p = 0.01). They were also at an increased risk of 30-day mortality (40% vs. 18.4%, p = 0.02), intensive care unit transfer (38.2% vs. 18.4%, p = 0.03) and endotracheal intubation (27.3% vs. 10.2%, p = 0.03). The afebrile state was also an independent risk factor associated with 30-day mortality in cirrhotic patients with bacteremia. Clinicians should perform a prudent evaluation in cirrhotic patients and carefully monitor for possible signs of serious infection even in the absence of fever.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-64644-7