Analysis of risk factors for poor prognosis in patients with renal insufficiency combined with Enterobacteriaceae bloodstream infection: a retrospective study.

BACKGROUND

This study analyzed the risk factors for poor prognosis in patients with Enterobacteriaceae bloodstream infections and co-occurring renal insufficiency. A nomogram prediction model was constructed to aid in clinical diagnosis and treatment.

METHODS

Data were retrospectively collected from patients admitted to the First People's Hospital of Jiande with positive blood culture results of Enterobacteriaceae combined with renal insufficiency. Patients were divided into survival and death groups according to clinical outcome, and independent risk factors for poor prognosis were screened using a multifactorial logistic regression analysis. A nomogram was subsequently established and validated.

RESULTS

The following risk factors and conditions were significantly associated with a higher patient mortality rate: male sex; admission to the ICU; comorbidity with shock, respiratory failure, coma, pneumonia, or leukaemia; the presence of carbapenem-resistant enterobacteriaceae (CRE) organisms; anaemia; thrombocytopenia; elevated D-dimer; hypo-proteinaemia; and hypocalcaemia (P < 0.05). Multifactorial logistic regression analysis suggested that shock, respiratory failure, and CRE bacterial bloodstream infection were independent risk factors for mortality in these patients.

CONCLUSIONS

This study established a nomogram prediction model of risk factors for poor prognosis in patients with renal insufficiency combined with Enterobacteriaceae bloodstream infection. This tool can assist clinicians in assessing patient prognosis at an early stage and, therefore, allow for more efficient intervention measures to reduce patient morbidity and mortality.