Survival following injury-related bloodstream infections across Queensland, Australia: a population-based data linkage study — The Association Specialists
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  3. Survival following injury-related bloodstream infections across Queensland, Australia: a population-based data linkage study

Survival following injury-related bloodstream infections across Queensland, Australia: a population-based data linkage study (23815)

Binuri Perera 1 2 , Kirsten Vallmuur 1 2 , Kevin Laupland 3 4 , Felicity Edwards 3 4 5 , Susanna Cramb 1 2
  1. Australian Centre for Health Services Innovation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
  2. Jamieson Trauma Institute, Metro North Health, Brisbane, Queensland, Australia
  3. Department of Intensive Care Services, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
  4. School of Clinical Medicine, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  5. Dietetics and Food Services, Royal Brisbane Women’s Hospital, Brisbane, Queensland, Australia

Bloodstream infections (BSI) represent a major infectious complication among injured patients, which can lead to death. Yet there is no understanding of survival among this population. This study aims to estimate population-level survival, including overall survival, relative survival, and crude probabilities of death, for injury-related BSIs in Queensland, Australia, and to examine the factors affecting survival.

Statewide linked data containing Queensland Hospital Admitted Patient Data Collection (QHAPDC), public pathology data and death data from the Queensland Death Registry from 2000 – 2019 were used for the analysis. Survival analysis up to one year follow-up was conducted using flexible parametric relative survival models incorporating time-varying effects to estimate the crude probability of death and to obtain the adjusted survival probabilities for each covariate (age, sex, injury severity, year of diagnosis, remoteness of the residential location, area-level socio-economic status, injury type, body region and isolate type). The analysis was conducted in Stata/SE 19 using the package stpm3.

Of the 3,097 Queenslanders with injury-related BSIs, there were 749 deaths recorded within the first year. The highest mortality was observed during the first 30 days following BSI diagnosis. The one-year overall survival was 75% (95% CI: 74.6 – 77.3), relative survival was 78% (95% CI: 76.6 – 79.5) and crude probability of death from injury-related BSIs was 0.22 and 0.02 for other causes. Poorer relative survival was seen among older adults, patients with severe injury, patients diagnosed with polymicrobial BSIs, patients with intracranial injuries and injuries to body regions defined as other.

These first population-level survival estimates revealed that it was predominantly patient and injury/microbial characteristics driving differences in relative survival. These findings demonstrate the need to closely monitor patients with identified patterns, initiate prompt treatment, and pursue further research in comparable cohorts to better understand and improve survival.