# Factors Associated with In-Hospital Mortality in Adult Patients with Community-Acquired Staphylococcus aureus Bacteremia: A Cross-Sectional Study

## TL;DR

This study identifies factors like older age, high CRP, and low albumin linked to higher in-hospital death rates in patients with community-acquired Staphylococcus aureus bloodstream infections.

## Contribution

The study provides new insights into clinical and laboratory predictors of mortality in CA-SAB patients.

## Key findings

- Older age is independently associated with in-hospital mortality in CA-SAB patients.
- Elevated C-reactive protein and lower serum albumin levels are significant predictors of mortality.
- Routine lab parameters like CRP and albumin may help identify high-risk patients early.

## Abstract

Community-acquired Staphylococcus aureus bacteremia (CA-SAB) is associated with substantial morbidity, mortality, and healthcare costs. This study aimed to identify clinical and laboratory factors associated with in-hospital mortality among patients with CA-SAB.

This retrospective cross-sectional study was conducted at a tertiary referral hospital in Tehran, Iran. Adult patients with positive blood cultures for S. aureus who met CA-SAB criteria were included. Demographic, clinical, and laboratory data were collected from medical records. The primary outcome was in-hospital mortality. Univariate and multivariate logistic regression analyses were performed to assess associations with mortality.

A total of 114 patients with CA-SAB were included. No significant association was observed between underlying comorbidities and mortality. Although methicillin-resistant S. aureus (MRSA) infection was associated with a higher mortality rate, this difference was not statistically significant (P = .32). Multivariate analysis revealed that older age (odds ratio [OR], 1.053; 95% CI, 1.012–1.095; P = .01), elevated C-reactive protein (CRP) levels (OR, 1.016; 95% CI, 1.005–1.028; P < .01), and lower serum albumin levels (OR, 0.249; 95% CI, 0.097–0.642; P < .01) were independently associated with in-hospital mortality.

Although age was not significant in univariate analysis, it emerged as a significant predictor after adjustment for other variables. Routine laboratory parameters such as CRP and albumin may serve as valuable prognostic indicators. Early identification of high-risk patients using these markers could inform timely interventions and improve outcomes in CA-SAB.