Table 3.
Admission resulting in hospital death
| All | Cluster 1 | Cluster 2 | Cluster 3 | |
|---|---|---|---|---|
| N = 315 (100%) | N = 229 (73%) | N = 47 (15%) | N = 39 (12%) | |
| Emergency admission | 292 (93%) | 214 (93%) | 43 (91%) | 35 (90%) |
| Planned admission | 26 (7%) | 15 (7%) | 4 (9%) | 4 (10%) |
| Medical | 236 (75%) | 172 (75%) | 35 (75%) | 29 (74%) |
| Surgical | 59 (19%) | 42 (18%) | 8 (17%) | 9 (23%) |
| Neurology | 12 (4%) | 10 (4%) | 2 (4%) | 0 |
| Orthopedic surgery | 7 (2%) | 5 (2%) | 2 (4%) | 0 |
| Gynecology | 0 | 0 | 0 | 0 |
| Ear–nose–throat | 1 (0%) | 0 | 0 | 1 (3%) |
| Infection present at admission | 219 (70%) | 157 (69%) | 35 (74%) | 27 (69%) |
| Infection acquired during admission | 96 (30%) | 72 (31%) | 12 (26%) | 12 (31%) |
| Site of infection | ||||
| Airways | 172 (55%) | 127 (55%) | 24 (51%) | 21 (54%) |
| Aspiration pneumonia | 29 (9%) | 20 (9%) | 5 (11%) | 4 (10%) |
| Skin or soft tissue | 7 (2%) | 5 (2%) | 2 (4%) | 0 |
| Urinary tract | 18 (6%) | 16 (7%) | 1 (2%) | 1 (3%) |
| Abdominal | 25 (8%) | 15 (7%) | 6 (13%) | 4 (10%) |
| Unknown | 83 (26%) | 62 (27%) | 11 (23%) | 10 (26%) |
| Foreign body, e.g., pacemaker | 1 (0%) | 1 (0%) | 0 | 0 |
| Central nervous system | 2 (1%) | 0 | 1 (2%) | 1 (3%) |
| Other, e.g., endocarditis | 7 (2%) | 3 (1%) | 2 (4%) | 2 (5%) |
| Infection following a procedure | ||||
| Most likely | 17 (5%) | 9 (4%) | 3 (6%) | 5 (13%) |
| Possibly | 22 (7%) | 15 (7%) | 6 (13%) | 1 (3%) |
| Highest level of care | ||||
| Ward | 102 (32%) | 93 (40%) | 9 (19%) | 0 |
| Intermediate ICU | 145 (46%) | 112 (49%) | 21 (45%) | 12 (31%) |
| ICU | 67 (21%) | 23 (10%) | 17 (36%) | 27 (70%) |
| ED | 1 (0%) | 1 (0%) | 0 | 0 |
| LOS | 6 (10) | 6 (8) | 7 (11) | 11 (16) |
| LOS intermediate ICU, if any | 2 (3) | 2 (3) | 4 (7) | 4 (11.5) |
| LOS ICU, if any | 7 (16) | 4 (6) | 6 (11) | 14 (16) |
| DNA-CPR prior to admission | 58 (18%) | 54 (24%) | 4 (9%) | 0 |
| DNA-CPR during admission | 240 (76%) | 170 (74%) | 36 (76%) | 32 (82%) |
| Patient declined further treatment | 20 (6%) | 13 (6%) | 3 (7%) | 4 (10%) |
| Location at death | ||||
| Ward | 179 (57%) | 152 (66%) | 22 (47%) | 5 (13%) |
| Intermediate ICU | 84 (27%) | 61 (27%) | 13 (28%) | 10 (26%) |
| ICU | 49 (16%) | 14 (6%) | 11 (23%) | 24 (62%) |
| ED | 1 (0%) | 1 (0%) | 0 | 0 |
| Radiology | 2 (1%) | 1 (0%) | 1 (2%) | 0 |
| QSOFA in ED ≥ 2, if infection at admission | 83 (38%) | 59 (38%) | 18 (51%) | 7 (26%) |
| Rise in SOFA score ≥ 2, ± 24 h. From suspicion of infection | 219 (70%) | 150 (66%) | 37 (79%) | 32 (82%) |
| If community acquired infection | 161 (74%) | 109 (69%) | 28 (80%) | 24 (89%) |
| If hospital acquired infection | 58 (60%) | 41 (57%) | 9 (75%) | 8 (66%) |
| If likely sepsis-related death | 149 (82%) | 100 (80%) | 25 (86%) | 23 (92%) |
| Sepsis-related death (very likely and likely) | 179 (57%) | 125 (55%) | 29 (62%) | 25 (64%) |
| Possibly sepsis-related death (credible and not excludable) | 136 (43%) | 104 (45%) | 18 (38%) | 14 (36%) |
Values are number (proportion) or median (IQR). Cluster 1: Age ≥ 85, CFS ≥ 7 or end-stage condition. Cluster 2: Age ≥ 80, CFS 6 or CCI ≥ 5. Cluster 3: Neither cluster 1 nor cluster 2
SOFA sequential organ failure assessment, qSOFA quick SOFA, ED emergency department, LOS length of stay, ICU intensive-care unit, DNA-CPR do not attempt cardiopulmonary resuscitation, ECMO extracorporeal membrane oxygenation