Table 3.
Riska of severe diseaseb according to selected demographic, clinical and laboratory characteristics of patients with iGAS notified to PAEDS Network hospitals, Australia, 1 July 2018 to 31 December 2022.
| Characteristic | Severe disease n/N (%) | Non-severe disease n/N (%) | Risk ratio (95% CI) |
|---|---|---|---|
| Year of presentation | |||
| 2018 | 17/43 (40%) | 26/43 (60%) | Reference group |
| 2019 | 16/58 (28%) | 42/58 (72%) | 0.7 (0.4, 1.2) |
| 2020 | 7/22 (32%) | 15/22 (68%) | 0.8 (0.4, 1.6) |
| 2021 | 8/38 (21%) | 30/38 (79%) | 0.5 (0.3, 1.1) |
| 2022 | 36/102 (35%) | 66/102 (65%) | 0.9 (0.6, 1.4) |
| Indigenous | 7/32 (22%) | 25/32 (78%) | 0.7 (0.3, 1.3) |
| Age <4 years | 51/152 (34%) | 101/152 (66%) | 1.1 (0.8, 1.6) |
| Female | 35/106 (33%) | 71/106 (67%) | 1.1 (0.7,1.5) |
| Presenting feature | |||
| GP/ED visit in previous 7 days | 63/182 (35%) | 119/182 (65%) | 1.3 (0.9, 2.0) |
| NSAID previous 7 days | 33/86 (38%) | 53/86 (62%) | 1.4 (0.9, 2.1) |
| Rash (any) | 41/107 (38%) | 66/107 (62%) | 1.5 (1.0, 2.1) |
| Petechial or purpuric rash | 12/28 (43%) | 16/28 (57%) | 1.4 (0.9, 2.2) |
| Fever | 75/230 (33%) | 155/230 (67%) | 1.4 (0.7, 2.9) |
| Limb pain | 21/94 (22%) | 73/94 (78%) | 0.7 (0.4, 1.0) |
| Bolus given within 4 h | 48/85 (56%) | 37/85 (44%) | 3.0 (2.0, 4.3) |
| Syndrome | |||
| Bacteraemia with no focus | 18/64 (28%) | 46/64 (72%) | 0.9 (0.5, 1.3) |
| STSS | 38/43 (88%) | 5/43 (12%) | 4.4 (3.3, 5.8) |
| Pneumonia | 42/68 (62%) | 26/68 (38%) | 2.9 (2.1, 4.0) |
| Empyema | 39/59 (66%) | 20/59 (34%) | 3.01 (2.19, 4.13) |
| NF | 1/6 (17%) | 5/6 (83%) | 0.5 (0.1, 3.1) |
| Skin and soft tissue infection excluding NF | 7/38 (18%) | 31/38 (82%) | 0.5 (0.3, 1.1) |
| Arthritis | 3/31 (9.7%) | 28/31 (90%) | 0.3 (0.1, 0.8) |
| Osteomyelitis | 4/32 (12%) | 28/32 (88%) | 0.4 (0.1, 0.9) |
| Meningitis | 3/5 (60%) | 2/5 (40%) | 1.9 (0.9, 4.0) |
| Other | 10/33 (30%) | 23/33 (70%) | 1.0 (0.5, 1.6) |
| Laboratory feature | |||
| Renal impairment | 26/32 (81%) | 6/32 (19%) | 3.2 (2.4, 4.3) |
| Liver impairment | 28/46 (61%) | 18/46 (39%) | 2.3 (1.6, 3.2) |
| Coagulopathy | 49/68 (72%) | 19/68 (28%) | 4.0 (2.9, 5.6) |
| Neutropenia | 8/11 (73%) | 3/11 (27%) | 2.5 (1.6, 3.7) |
| Respiratory virus co-infection | 25/57 (44%) | 32/57 (56%) | 1.9 (1.2, 3.0) |
GP, general practitioner; ED, emergency department; NSAID, non-steroidal anti-inflammatory drug; NF, necrotising fasciitis; STSS, streptococcal toxic shock syndrome.
Bold denotes statistical significance.
a
Univariate risk ratio using binomial regression STATA 17 (Stata Corporation, College Station, TX).
b
Severe disease was defined as intensive care admission, or any of mechanical ventilation, inotropes, vasopressors or extracorporeal membrane oxygenation.