The exclusion criteria were antibiotic treatment whatever the antibiotic was within 7 days before enrolment and severe underlying disease.
32 Our finding that concurrent treatment with benzodiazepines and higher dose opioids was associated with increased mortality might be a true adverse effect or reflect more severe underlying disease that requires higher doses to relieve symptoms.
This might reflect the changing landscape of coronary intervention characterised by more patients with coronary artery disease undergoing treatment by percutaneous revascularisation (e.g. balloon angioplasty and stenting), while surgical revascularisation (CABG) is reserved for patients with more comorbid conditions and more severe underlying disease [ 24].
As in previous studies of S. aureus bacteremia, older age, use of immunosuppressants, severe underlying disease, high severity of illness, and inappropriate definitive antibiotics were independent risk factors for mortality [ 8, 20- 22].
Maintaining fidelity is challenged by the complex, multi-domain design of the intervention implemented across multiple sites and delivered to an older, heterogeneous participant pool with severe underlying disease and multi-morbidity.
Conclusions: Critically ill patients in whom HSV-1 from BAL is isolated, have about 40% chance of dying, mainly because of severe underlying disease and comorbidity, which may predispose to endogenous reactivation of the virus.
However, it has also been suggested that severe underlying disease is the cause of death while hyponatraemia is merely another complication of this underlying disease.
Those with more severe underlying disease have more frequent exacerbations: in mild disease 1.8 per year, moderate 2 to 3 per year, and severe 3.4 per year.
Subjects compared were those presenting acutely and excluded those with underlying immunosuppression or severe underlying disease (see Methods for criteria to assign disease categories).
