Table 2.
Result of the semi-markov model with penalized likelihood estimation incorporating frailty terms: HR (exp(β)) estimates and corresponding confidences intervals for the different transition intensities
|
Three independent frailties for transitions 01, 02 and 03 |
01 (VAP) |
02 (death) |
03 (discharge) |
|||
|---|---|---|---|---|---|---|
| exp(β) | 95%CI | exp(β) | 95%CI | exp(β) | 95%CI | |
| Sex (men=1) |
1.51 |
(1.23-1.87) |
- |
- |
0.85 |
(0.78-0.94) |
|
Age ≥ 62 |
- |
- |
- |
- |
0.95 |
(0.86-1.05) |
| 33 < SAPSII ≤ 45 |
- |
- |
1.62 |
(1.03-2.54) |
0.66 |
(0.58-0.75) |
| 45 < SAPSII ≤ 58 |
- |
- |
2.70 |
(1.75-4.14) |
0.56 |
(0.49-0.64) |
| 58 < SAPSII |
- |
- |
4.83 |
(3.18-7.35) |
0.40 |
(0.34-0.47) |
| Type of Admission : |
|
|
|
|
|
|
| Elective surgery |
1 |
|
- |
- |
1 |
|
| Emergency surgery |
0.58 |
(0.41-0.83) |
- |
- |
1.04 |
(0.90-1.20) |
| Medicine |
0.89 |
(0.66-1.20) |
- |
- |
0.96 |
(0.82-1.12) |
| Chronic diseases |
- |
- |
1.37 |
(1.14-1.66) |
0.84 |
(0.76-0.92) |
| Diabetes |
1.48 |
(1.10-2.00) |
1.30 |
(0.97-1.76) |
- |
- |
|
Diagnostic or symptoms on ICU admission: |
|
|
|
|
||
| ARDS |
1.71 |
(1.16-2.54) |
- |
- |
- |
- |
| Trauma |
2.52 |
(1.12-5.67) |
- |
- |
- |
- |
| Coma |
1.23 |
(0.95-1.60) |
2.90 |
(1.99-4.22) |
1.06 |
(0.91-1.25) |
| Shock |
1.21 |
(0.96-1.53) |
2.12 |
(1.47-3.06) |
0.73 |
(0.63-0.84) |
| Acute respiratory failure |
- |
- |
1.79 |
(1.22-2.62) |
0.65 |
(0.56-0.75) |
|
Use in the first 24 h of ICU admission : |
|
|
|
|
||
| Antimicrobials |
0.61 |
(0.50-0.75) |
0.66 |
(0.54-0.81) |
0.86 |
(0.77-0.95) |
| Inotropes |
- |
- |
- |
- |
0.74 |
(0.67-0.82) |
| Enteral nutrition |
1.21 |
(0.97-1.50) |
0.76 |
(0.60-0.95) |
0.62 |
(0.55-0.71) |
| Parenteral nutrition |
- |
- |
- |
- |
1.00 |
(0.87-1.14) |
| Variance of the frailty γ (SE) |
0.19(0.11) |
0.09(0.06) |
0.15(0.07) |
|||
|
Two independent frailties for transitions 12 and 13 |
12 (death with VAP) |
13 (discharge with VAP) |
|
|
||
| |
exp(β) |
95%CI |
exp(β) |
95%CI |
|
|
|
Age ≥ 62 |
- |
- |
0.84 |
(0.66-1.07) |
|
|
| 33 < SAPSII ≤ 45 |
2.13 |
(1.05-4.31) |
- |
- |
|
|
| 45 < SAPSII ≤ 58 |
2.60 |
(1.27-5.31) |
- |
- |
|
|
| 58 < SAPSII |
4.81 |
(2.38-9.72) |
- |
- |
|
|
| Parenteral nutrition |
- |
|
0.70 |
(0.51-0.97) |
|
|
| Variance of the frailty γ (SE) |
0.04(0.06) |
0.11(0.08) |
|
|
||
|
A joint subject-specific frailtyterm for transitions 12 and 13 |
12 (death with VAP) |
13 (discharge with VAP) |
|
|
||
| |
exp(β) |
95%CI |
exp(β) |
95%CI |
|
|
|
Age ≥ 62 |
- |
- |
0.78 |
(0.61-0.98) |
|
|
| 33 < SAPSII ≤ 45 |
2.22 |
(0.99-4.97) |
- |
- |
|
|
| 45 < SAPSII ≤ 58 |
2.65 |
(1.17-6.01) |
- |
- |
|
|
| 58 < SAPSII |
5.19 |
(2.31-11.65) |
- |
- |
|
|
| Parenteral nutrition |
- |
|
0.67 |
(0.49-0.90) |
|
|
| Common frailty variance η (SE) |
0.77 (0.13) |
|
|
|
|
|
| Power coefficient ζ (from ηζ) | -0.16 (0.29) | |||||
−: the corresponding covariate has not been selected for this transition by the descendant strategy based on model without frailties. SAPS II = Simplified Acute Physiology Score, version II at admission (33, 45, and 58 separate the four quartiles); ARDS = Acute Respiratory Distress Syndrome; Acute Respiratory failure: indicate the need for respiratory supportive therapy; Coma: admission for a neurological disease and a Glasgow coma score of less than 9; Shock: admission in the ICU with sign or symptoms of shock according to common definitions.