Table 2.
Univariate and multivariate analysis of risk factors for clinical failure at 96 h
| Variable | Result by analysis type |
|||||
|---|---|---|---|---|---|---|
| Univariate |
Multivariate |
|||||
| No. (%) with clinical failure (n = 83) | No. (%) with clinical cure (n = 98) | Unadjusted OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
| Demographics | ||||||
| Male gender | 40 (49.4) | 41 (42.3) | 1.33 (0.74, 2.41) | 0.34 | ||
| Age ≥65 yr | 32 (38.6) | 50 (51.5) | 0.59 (0.33, 1.07) | 0.08 | 0.43 (0.20, 0.95) | 0.04 |
| White race | 46 (58.2) | 52 (56.5) | 1.07 (0.58, 1.97) | 0.82 | ||
| Location of acquisition | 0.002 | |||||
| Community associated | 11 (13.3) | 7 (7.1) | Baseline | |||
| Health care associated | 35 (42.2) | 67 (68.4) | 0.33 (0.12, 0.93) | |||
| Hospital acquired | 37 (44.6) | 24 (24.5) | 0.98 (0.33, 2.88) | |||
| Health care-associated risk factor | ||||||
| Any hospitalization in past year | 66 (84.6) | 72 (79.1) | 1.45 (0.65, 3.22) | 0.36 | ||
| Any hospitalization in past 90 days | 55 (69.6) | 63 (67.0) | 1.13 (0.59, 2.15) | 0.71 | ||
| Any nursing home admission in past 90 days | 11 (13.9) | 23 (24.5) | 0.50 (0.23, 1.10) | 0.09 | ||
| Any surgery in past 90 days | 42 (53.2) | 35 (37.2) | 1.91 (1.04, 3.52) | 0.04 | ||
| Dialysis in past 90 days | 12 (15.2) | 5 (5.3) | 3.19 (1.07, 9.48) | 0.04 | ||
| Outpatient intravenous therapy in past 90 days | 5 (6.3) | 14 (14.9) | 0.39 (0.13, 1.12) | 0.08 | ||
| Other home therapy in past 90 days | 3 (3.8) | 2 (2.1) | 1.82 (0.30, 11.15) | 0.52 | ||
| Antimicrobials in 90 days prior to enrollment | 49 (62.0) | 64 (68.1) | 0.77 (0.41, 1.43) | 0.40 | ||
| Hospital clinic in 30 days prior to enrollment | 21 (26.6) | 45 (48.9) | 0.38 (0.20, 0.72) | 0.003 | ||
| Dialysis clinic in 30 days prior to enrollment | 9 (11.4) | 2 (2.2) | 5.79 (1.21, 27.63) | 0.03 | ||
| Chemotherapy in 30 days prior to enrollment | 3 (3.8) | 8 (8.7) | 0.41 (0.11, 1.62) | 0.21 | ||
| Systemic corticosteroids in 30 days prior to enrollment | 10 12.7) | 9 (9.8) | 1.34 (0.51, 3.47) | 0.55 | ||
| Other immunosuppressive therapy in 30 days prior to enrollment | 10 (12.7) | 8 (8.7) | 1.52 (0.57, 4.07) | 0.40 | ||
| Radiation therapy in 30 days prior to enrollment | 0 (0.0) | 1 (1.1) | 1.17a (0.00, 45.42) | 1.00 | ||
| Urinary catheter at enrollment | 21 (25.9) | 35 (35.7) | 0.63 (0.33, 1.20) | 0.16 | ||
| Vascular catheter at enrollment | 32 (39.5) | 24 (24.5) | 2.01 (1.06, 3.82) | 0.03 | ||
| Underlying disease | ||||||
| Diabetes | 30 (36.1) | 35 (35.7) | 1.02 (0.55, 1.87) | 0.95 | ||
| Chronic pulmonary disease | 11 (13.3) | 18 (18.4) | 0.68 (0.30, 1.53) | 0.35 | ||
| Cardiovascular disease | 43 (51.8) | 31 (31.6) | 2.32 (1.27, 4.26) | 0.006 | 2.88 (1.29, 6.43) | 0.01 |
| Peripheral vascular disease | 6 (7.2) | 4 (4.1) | 1.83 (0.50, 6.72) | 0.36 | ||
| Cerebrovascular disease | 13 (15.7) | 20 (20.4) | 0.72 (0.34, 1.56) | 0.41 | ||
| Dementia | 5 (6.0) | 14 (14.3) | 0.38 (0.13, 1.12) | 0.08 | ||
| Peptic ulcer disease | 1 (1.2) | 2 (2.0) | 0.59 (0.05, 6.57) | 0.66 | ||
| Liver disease | 13 (15.7) | 10 (10.2) | 1.63 (0.68, 3.95) | 0.28 | ||
| Chronic renal failure | 17 (20.5) | 10 (10.2) | 2.27 (0.97, 5.27) | 0.06 | ||
| Connective tissue disease | 2 (2.4) | 1 (1.0) | 2.39 (0.21, 26.89) | 0.48 | ||
| HIV infection | 0 (0.0) | 3 (3.1) | 0.30a (0.00, 2.84) | 0.31 | ||
| Malignancy within last 5 years | 17 (20.5) | 21 (21.4) | 0.94 (0.46, 1.94) | 0.88 | ||
| Solid organ malignancy | 13 (15.7) | 12 (12.2) | 1.33 (0.57, 3.10) | 0.51 | ||
| Transplant recipient | 13 (15.7) | 12 (12.2) | 1.33 (0.57, 3.10) | 0.51 | ||
| McCabe-Jackson score D | 11 (13.4) | 36 (36.7) | 0.27 (0.13, 0.57) | 0.0006 | 0.39 (0.16, 0.95) | 0.04 |
| Factor associated with treatment | ||||||
| Carbapenem use in 48 h after infection | 12 (14.5) | 24 (24.5) | 0.52 (0.24, 1.12) | 0.10 | ||
| Appropriate antimicrobials in first 48 h | 31 (37.3) | 46 (46.9) | 0.67 (0.37, 1.22) | 0.19 | ||
| Appropriate antimicrobials in first 72 h | 38 (45.8) | 66 (67.3) | 0.41 (0.22, 0.75) | 0.004 | 0.42 (0.20, 0.88) | 0.02 |
| Appropriate antimicrobials in first 96 h | 52 (62.7) | 77 (78.6) | 0.46 (0.24, 0.88) | 0.02 | ||
| Appropriate definitive therapy | 61 (79.2) | 87 (88.8) | 0.48 (0.21, 1.11) | 0.09 | ||
| Source of infection | 0.0001 | 0.008 | ||||
| Urinary tract | 26 (31.3) | 65 (67.0) | Baseline | Baseline | ||
| Intra-abdominal | 8 (9.6) | 4 (4.1) | 5.00 (1.39, 18.0) | 6.35 (1.51, 26.7) | ||
| Line-related infection | 3 (3.6) | 6 (6.2) | 1.25 (0.29, 5.38) | 0.86 (0.18, 4.21) | ||
| Primary bacteremia | 6 (7.2) | 7 (7.2) | 2.14 (0.66, 6.98) | 1.83 (0.51, 6.56) | ||
| Respiratory tract infection | 15 (18.1) | 7 (7.2) | 5.36 (1.96, 14.6) | 2.85 (0.94, 8.66) | ||
| Surgical site infection | 5 (6.0) | 3 (3.1) | 4.17 (0.93, 18.7) | 2.69 (0.54, 13.5) | ||
| Other source or multiple sources | 20 (24.1) | 5 (5.2) | 10.0 (3.39, 29.5) | 8.12 (2.30, 28.6) | ||
a
OR were estimated using median unbiased estimates.