Table 4.
In-hospital mortality in patients with community acquired severe sepsis at Haukeland University Hospital in 2008
| |
All
a
|
Non-survivors |
Unadjusted models |
Fully adjusted model
b
|
Final model
c
|
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristic | n | n | (%) | OR | 95% CI | P value | OR | 95% CI | P value | OR | 95% CI | P value |
| Gender |
|
|
|
|
|
0.240 |
|
|
|
|
|
|
| Male |
117 |
33 |
(28.2) |
1.00 |
Reference |
|
|
|
|
|
|
|
| Female |
103 |
22 |
(21.4) |
0.69 |
(0.37, 1.29) |
|
|
|
|
|
|
|
| Age (years) |
|
|
|
|
|
0.065 |
|
|
0.619 |
|
|
|
| 16-30 |
18 |
1 |
(5.6) |
1.00 |
Reference |
|
1.00 |
Reference |
|
|
|
|
| 30-45 |
22 |
4 |
(18.2) |
3.78 |
(0.38, 37.28) |
|
0.99 |
(0.07, 14.18) |
|
|
|
|
| 45-60 |
36 |
8 |
(22.2) |
4.86 |
(0.56, 42.30) |
|
2.27 |
(0.19, 26.64) |
|
|
|
|
| 60-75 |
68 |
16 |
(23.5) |
5.23 |
(0.65, 42.43) |
|
2.88 |
(0.28, 29.54) |
|
|
|
|
| ≥75 |
76 |
26 |
(34.2) |
8.84 |
(1.11, 70.18) |
|
3.09 |
(0.28, 33.54) |
|
|
|
|
| Comorbidity |
|
|
|
|
|
|
|
|
|
|
|
|
| None |
23 |
1 |
(4.3) |
0.12 |
(0.02, 0.92) |
0.005 |
|
|
|
|
|
|
| Hypertension |
91 |
18 |
(19.8) |
0.61 |
(0.32, 1.17) |
0.130 |
|
|
|
|
|
|
| Cardiovascular |
107 |
35 |
(32.7) |
2.26 |
(1.20, 4.24) |
0.010 |
2.18 |
(0.85, 5.61) |
0.101 |
3.29 |
(1.45, 7.48) |
0.003 |
| Pulmonary |
61 |
14 |
(23.0) |
0.86 |
(0.43, 1.72) |
0.662 |
|
|
|
|
|
|
| Diabetes |
38 |
9 |
(23.7) |
0.92 |
(0.40, 2.08) |
0.836 |
|
|
|
|
|
|
| Malignancy |
31 |
13 |
(41.9) |
2.53 |
(1.15, 5.58) |
0.025 |
5.97 |
(1.96, 18.19) |
0.001 |
5.50 |
(1.92, 15.78) |
0.001 |
| Dementia |
17 |
6 |
(35.3) |
1.71 |
(0.60, 4.88) |
0.324 |
|
|
|
|
|
|
| Psychiatric |
51 |
9 |
(17.6) |
0.57 |
(0.26, 1.27) |
0.155 |
|
|
|
|
|
|
| Substance abuse |
31 |
6 |
(19.4) |
0.69 |
(0.27, 1.77) |
0.423 |
|
|
|
|
|
|
| Otherd |
74 |
27 |
(36.5) |
2.42 |
(1.29, 4.53) |
0.006 |
2.52 |
(1.11, 5.70) |
0.025 |
2.43 |
(1.10, 5.35) |
0.026 |
| Correct suspected focus of infection |
|
|
|
|
|
0.020 |
|
|
0.606 |
|
|
|
| Yes |
152 |
31 |
(20.4) |
1.00 |
Reference |
|
1.00 |
Reference |
|
|
|
|
| No |
68 |
24 |
(35.3) |
2.13 |
(1.13, 4.02) |
|
0.79 |
(0.33, 1.91) |
|
|
|
|
| Confirmed focus of infection |
|
|
|
|
|
0.007 |
|
|
0.003 |
|
|
0.001 |
| Respiratory |
115 |
25 |
(21.7) |
1.00 |
Reference |
|
1.00 |
Reference |
|
|
|
|
| Genitourinary |
31 |
4 |
(12.9) |
0.53 |
(0.17, 1.67) |
|
0.41 |
(0.08, 2.21) |
|
0.47 |
(0.09, 2.39) |
|
| Soft tissue |
27 |
6 |
(22.2) |
1.03 |
(0.38, 2.82) |
|
2.04 |
(0.55, 7.60) |
|
2.42 |
(0.68, 8.68) |
|
| Abdominal |
26 |
12 |
(46.2) |
3.09 |
(1.27, 7.51) |
|
2.95 |
(0.87, 10.03) |
|
3.54 |
(1.09, 11.43) |
|
| Endocarditis |
12 |
7 |
(58.3) |
5.04 |
(1.47, 17.25) |
|
17.43 |
(2.74, 111.06) |
|
18.94 |
(3.45, 104.06) |
|
| Bacteremia |
5 |
0 |
(0.0) |
0.00 |
(0.00, ) |
|
0.00 |
(0.00, ) |
|
0.00 |
(0.00, ) |
|
| CNS |
4 |
1 |
(25.0) |
1.20 |
(0.12, 12.04) |
|
9.22 |
(0.71, 118.97) |
|
7.66 |
(0.63, 93.73) |
|
| Microbiological samples |
|
|
|
|
|
0.008 |
|
|
0.028 |
|
|
0.025 |
| Positive |
129 |
24 |
(18.6) |
1.00 |
Reference |
|
1.00 |
Reference |
|
1.00 |
Reference |
|
| Negative |
83 |
26 |
(31.3) |
2.00 |
(1.05, 3.79) |
|
3.58 |
(1.34, 9.55) |
|
3.34 |
(1.29, 8.63) |
|
| Not obtained |
8 |
5 |
(62.5) |
7.29 |
(1.63, 32.63) |
|
2.91 |
(0.35, 24.09) |
|
4.44 |
(0.60, 32.95) |
|
| Empirical antimicrobial agents |
|
|
|
|
|
|
|
|
|
|
|
|
| Suspected focus of infection |
|
|
|
|
|
0.433 |
|
|
|
|
|
|
| Appropriate compliance |
171 |
38 |
(22.2) |
1.00 |
Reference |
|
|
|
|
|
|
|
| Inappropriate compliance |
39 |
11 |
(28.2) |
1.38 |
(0.63, 3.02) |
|
|
|
|
|
|
|
| Confirmed focus of infection |
|
|
|
|
|
0.027 |
|
|
0.241 |
|
|
|
| Appropriate |
168 |
35 |
(21.0) |
1.00 |
Reference |
|
1.00 |
Reference |
|
|
|
|
| Inappropriate |
52 |
19 |
(36.5) |
2.17 |
(1.10, 4.27) |
|
0.79 |
(0.33, 1.91) |
|
|
|
|
| Microbiological aetiologye |
|
|
|
|
|
< 0.001 |
|
|
|
|
|
|
| Adequate |
106 |
12 |
(11.3) |
1.00 |
Reference |
|
|
|
|
|
|
|
| Inadequate |
23 |
12 |
(52.2) |
8.55 |
(3.10, 23.58) |
|
|
|
|
|
|
|
| In-hospital initial dose administered |
|
|
|
|
|
0.002 |
|
|
0.051 |
|
|
0.046 |
| <6 hours after admission |
157 |
30 |
(19.1) |
1.00 |
Reference |
|
1.00 |
Reference |
|
1.00 |
Reference |
|
| ≥6 hours after admission |
54 |
22 |
(40.7) |
2.91 |
(1.49, 5.71) |
|
2.52 |
(1.00, 6.38) |
|
2.48 |
(1.02, 6.02) |
|
| Pre-hospital administration |
|
|
|
|
|
0.059 |
|
|
0.055 |
|
|
0.041 |
| No |
205 |
48 |
(23.4) |
1.00 |
Reference |
|
1.00 |
Reference |
|
1.00 |
Reference |
|
| Yes | 15 | 7 | (46.7) | 2.86 | (0.99, 8.30) | 4.13 | (0.99, 17.21) | 4.20 | (1.08, 16.39) | |||
Abbreviations: OR: odds ratio; CI: confidence interval.
an = 220.
bIncludes all categories with P < 0.10 in the unadjusted analyses; n = 211; Hosmer-Lemeshow’s chi-square = 12.38, df = 8, P = 0.135.
cFrom backward stepwise selection at significance level 0.05; n = 211; Hosmer-Lemeshow’s chi-square = 3.18, df = 8, P = 0.923.
dIncluding chronic kidney, liver and rheumatic diseases.
eNot included in multivariate analysis due to a substantial number of not applicable cases (if included, significant in multivariate analysis).