Table 4.
Results of adjusted difference-in-differences analysis for safety outcomes
| Outcome | Eligible Subjects |
Adjusted Change or Odds Ratio (95% CI) | P Value | |
|---|---|---|---|---|
| Included in Analysis | Missing Covariate Data | |||
| Antimicrobial ≤24 h from ED arrival | ||||
| All ED patients | 173,879 | 6,523 (3.6%) | aOR = 1.08 (1.02–1.14) | 0.01 |
| “High sepsis risk at triage” patients | 4,936 | 0 | aOR = 1.48 (1.10–1.98) | 0.009 |
| Unnecessary antimicrobials in ED | ||||
| Patients who met sepsis criteria in the ED with infection absent on final adjudication | 10,151 | 0 | aOR = 1.38 (1.02–1.87) | 0.04 |
| Receipt of antimicrobial in ED among “sepsis-mimic” cohort patients | 3,850 | 122 (3.1%) | aOR = 0.77 (0.42–1.41) | 0.39 |
| Totaled spectrum scores for unique antibiotics received within 24 h of ED arrival* | ||||
| ED patients with sepsis | 10,027 | 0 | +0.32 (0.06–0.58) | 0.02 |
| All ED patients | 24,026 | 485 (2.0%) | +0.16 (0.02–0.29) | 0.02 |
| “High sepsis risk at triage” cohort patients | 3,380 | 0 | +0.02 (−0.43–0.48) | 0.93 |
| Possible antimicrobial-related AE | ||||
| ED patients with sepsis | 10,151 | 0 | aOR = 1.09 (0.68–1.75) | 0.73 |
| All ED patients | 173,879 | 6,523 (3.6%) | aOR = 1.01 (0.77–1.32) | 0.97 |
| New-onset Clostridioides difficile infection | ||||
| ED patients with sepsis | 10,038 | 0 | aOR = 1.03 (0.49–2.17) | 0.94 |
| All ED patients | 173,593 | 6,522 (3.6%) | aOR = 1.37 (0.90–2.08) | 0.14 |
Definition of abbreviations: AE = adverse effect; aOR = adjusted odds ratio; CI = confidence interval; ED = emergency department.
*
Patients who did not receive an antimicrobial agent within 24 hours of ED arrival or who received only antiviral and/or antifungal agents during this window were excluded from analyses of antibiotic spectrum.