Abstract
P-44. Trend of Palliative Care Consult Among Patients with Staphylococcus aureus Bacteremia at a Mid-west Referral Center Between 2016 and 2018
Open forum infectious diseases, Vol.13(Supplement_1)
01/11/2026
DOI: 10.1093/ofid/ofaf695.273
Abstract
Background Staphylococcus aureus bacteremia (SAB) remains a leading cause of bloodstream infection in both community and healthcare settings, with reported mortality rates ranging from 10% to 30%. This study aimed to characterize the frequency, predictors, and clinical impact of palliative care consultation (PCC) in hospitalized patients with SAB. Methods We conducted a retrospective cohort study of adult and pediatric inpatients with SAB, defined by ≥1 positive blood culture for S. aureus, between January 1, 2016, and December 31, 2018. Baseline characteristics were compared between patients who did and did not receive PCC using chi-square, Fisher’s exact, and Wilcoxon rank-sum tests. Temporal trends, predictors of PCC, and associated outcomes were assessed using multivariable regression models. Survival was analyzed using Kaplan-Meier methods. Results Among 479 patients with SAB, 89 (18.6%) received PCC. Although PCC use increased over time, the trend was not statistically significant. Goals-of-care (GoC) discussions were the most common indication. Independent predictors of PCC included older age (adjusted odds ratio [aOR], 1.03 per year; 95% CI, 1.02–1.05; P< 0.001) and prolonged bacteremia (aOR, 1.10 per day; 95% CI, 1.00–1.21; P=0.042). Female sex (aOR, 0.54; 95% CI, 0.29–0.97; P=0.043) and musculoskeletal/soft tissue source of infection (aOR, 0.35; 95% CI, 0.14–0.83; P=0.021) were associated with lower odds of PCC. PCC was associated with shorter antibiotic duration (aOR, 0.58; 95% CI, 0.55–0.61; P< 0.001), increased GoC documentation (aOR, 1369.48; 95% CI, 257.29–25,917.74; P< 0.001), and higher rates of transition to comfort care (aOR, 42.40; 95% CI, 19.96–98.50; P< 0.001) and hospice (aOR, 164.34; 95% CI, 26.55–360.32; P< 0.001). Median time from consultation to discharge was 4 days (IQR, 1–10), and was shorter among those who died in-hospital (2 vs. 8 days; P< 0.0001). Conclusion PCC was infrequently utilized among patients with SAB but strongly associated with care transitions and antimicrobial stewardship outcomes. A substantial proportion of patients died without PCC involvement. These findings highlight the need for earlier integration of palliative care in the management of SAB to support patient-centered care. Disclosures Paul G. Auwaerter, MD, Capricor: Board Member|Capricor: Stocks/Bonds (Public Company)|Johnson and Johnson: Stocks/Bonds (Public Company)|Pfizer: Grant/Research Support|Shionogi: Advisor/Consultant
Details
- Title: Subtitle
- P-44. Trend of Palliative Care Consult Among Patients with Staphylococcus aureus Bacteremia at a Mid-west Referral Center Between 2016 and 2018
- Creators
- Mariana Kim Hsieh - University of IowaPatrick M Mallea - Oregon Health & Science UniversityBenjamin C Chen - Loma Linda UniversityPatrick Schwartzhoff - University of Vermont Medical CenterAlexandre Marra - University of IowaKunatum Prasidthrathsint - University of IowaYuya Hagiwara - University of IowaBeth A Hanna - University of IowaJaime P Murphy - University of IowaPaul G Auwaerter - Johns Hopkins UniversityKaren Brust - University of IowaTakaaki Kobayashi - University of Kentucky
- Resource Type
- Abstract
- Publication Details
- Open forum infectious diseases, Vol.13(Supplement_1)
- DOI
- 10.1093/ofid/ofaf695.273
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Publisher
- Oxford University Press
- Language
- English
- Date published
- 01/11/2026
- Academic Unit
- Infectious Diseases; Pathology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9985121596102771
Metrics
1 Record Views