Table 3.
Multivariable model examining characteristics associated with cause–specific infection–related hospitalization
| Variable | Bloodstream Infection or Sepsis | Dialysis Access Infection | Pulmonary Infection | Other Infection | ||||
|---|---|---|---|---|---|---|---|---|
| RR (95% CI) | P Value | RR (95% CI) | P Value | RR (95% CI) | P Value | RR (95% CI) | P Value | |
| Age, yrs | ||||||||
| 18–44 | 0.86 (0.79 to 0.94) | <0.001 | 1.34 (1.26 to 1.42) | <0.001 | 0.98 (0.90 to 1.07) | 0.62 | 1.07 (0.99 to 1.15) | 0.08 |
| 45–64 | Reference | Reference | Reference | Reference | ||||
| 65–74 | 1.19 (1.13 to 1.26) | <0.001 | 0.84 (0.80 to 0.88) | <0.001 | 1.17 (1.10 to 1.23) | <0.001 | 1.00 (0.95 to 1.06) | 0.97 |
| 75–84 | 1.39 (1.31 to 1.47) | <0.001 | 0.82 (0.78 to 0.87) | <0.001 | 1.36 (1.28 to 1.45) | <0.001 | 1.11 (1.05 to 1.18) | <0.001 |
| ≥85 | 1.57 (1.44 to 1.71) | <0.001 | 0.93 (0.85 to 1.01) | 0.08 | 1.61 (1.48 to 1.75) | <0.001 | 1.26 (1.16 to 1.38) | <0.001 |
| Men | 0.91 (0.87 to 0.95) | <0.001 | 0.90 (0.87 to 0.93) | <0.001 | 0.90 (0.86 to 0.94) | <0.001 | 0.72 (0.69 to 0.75) | <0.001 |
| Race | ||||||||
| White | Reference | Reference | Reference | Reference | ||||
| Black | 0.92 (0.87 to 0.98) | <0.01 | 0.95 (0.90 to 1.00) | 0.05 | 0.68 (0.64 to 0.72) | <0.001 | 0.66 (0.63 to 0.70) | <0.001 |
| Other | 0.89 (0.79 to 1.00) | 0.05 | 0.98 (0.89 to 1.09) | 0.74 | 0.86 (0.77 to 0.95) | 0.004 | 0.68 (0.61 to 0.76) | <0.001 |
| Hispanic | 0.86 (0.79 to 0.93) | <0.001 | 0.92 (0.85 to 0.99) | 0.03 | 0.89 (0.82 to 0.97) | <0.01 | 0.87 (0.81 to 0.94) | <0.001 |
| Body mass index, kg/m2 | ||||||||
| <20 | 1.14 (1.06 to 1.24) | <0.001 | 1.02 (0.95 to 1.10) | 0.53 | 1.20 (1.12 to 1.29) | <0.001 | 1.02 (0.94 to 1.11) | 0.57 |
| 20–24 | Reference | Reference | Reference | Reference | ||||
| 25–29 | 0.97 (0.92 to 1.02) | 0.24 | 0.95 (0.91 to 1.00) | 0.07 | 0.88 (0.83 to 0.92) | <0.001 | 0.98 (0.93 to 1.03) | 0.44 |
| 30–34 | 0.95 (0.89 to 1.01) | 0.10 | 0.95 (0.90 to 1.01) | 0.08 | 0.81 (0.76 to 0.86) | <0.001 | 1.06 (1.00 to 1.13) | 0.05 |
| ≥35 | 1.00 (0.94 to 1.06) | >0.99 | 1.05 (1.00 to 1.11) | 0.07 | 0.75 (0.70 to 0.80) | <0.001 | 1.16 (1.10 to 1.23) | <0.001 |
| Congestive heart failure | 1.13 (1.09 to 1.18) | <0.001 | 1.02 (0.98 to 1.06) | 0.36 | 1.15 (1.10 to 1.21) | <0.001 | 1.07 (1.03 to 1.12) | 0.001 |
| Atherosclerotic heart disease | 0.99 (0.94 to 1.04) | 0.71 | 0.97 (0.93 to 1.02) | 0.29 | 0.99 (0.94 to 1.05) | 0.81 | 1.04 (0.99 to 1.09) | 0.16 |
| Cerebrovascular disease | 1.19 (1.12 to 1.26) | <0.001 | 1.11 (1.05 to 1.17) | <0.001 | 1.07 (1.01 to 1.14) | 0.03 | 1.10 (1.03 to 1.16) | 0.003 |
| Peripheral vascular disease | 1.12 (1.06 to 1.19) | <0.001 | 1.13 (1.07 to 1.19) | <0.001 | 1.01 (0.95 to 1.07) | 0.70 | 1.11 (1.05 to 1.17) | <0.001 |
| Hypertension | 0.75 (0.71 to 0.80) | <0.001 | 0.87 (0.82 to 0.92) | <0.001 | 0.91 (0.85 to 0.97) | 0.003 | 0.84 (0.79 to 0.90) | <0.001 |
| History of amputation | 1.31 (1.18 to 1.45) | <0.001 | 1.15 (1.05 to 1.26) | 0.004 | 1.04 (0.92 to 1.18) | 0.53 | 1.21 (1.09 to 1.34) | <0.001 |
| Diabetes mellitus | 1.24 (1.18 to 1.30) | <0.001 | 1.11 (1.06 to 1.16) | <0.001 | 1.03 (0.99 to 1.08) | 0.15 | 1.28 (1.22 to 1.34) | <0.001 |
| COPD | 1.20 (1.13 to 1.29) | <0.001 | 1.10 (1.03 to 1.18) | 0.003 | 1.78 (1.68 to 1.89) | <0.001 | 1.05 (0.98 to 1.12) | 0.17 |
| Cancer | 1.28 (1.19 to 1.38) | <0.001 | 1.11 (1.03 to 1.20) | <0.01 | 1.19 (1.10 to 1.28) | <0.001 | 1.18 (1.09 to 1.28) | <0.001 |
| Inability to ambulate or transfer | 1.57 (1.46 to 1.69) | <0.001 | 1.21 (1.12 to 1.31) | <0.001 | 1.11 (1.02 to 1.22) | 0.02 | 1.32 (1.22 to 1.42) | <0.001 |
| Vascular access type | ||||||||
| AV fistula | Reference | Reference | Reference | Reference | ||||
| Catheter | 1.54 (1.44 to 1.65) | <0.001 | 3.07 (2.82 to 3.36) | <0.001 | 1.14 (1.07 to 1.22) | <0.001 | 1.32 (1.24 to 1.40) | <0.001 |
| AV graft | 1.41 (1.28 to 1.57) | <0.001 | 2.36 (2.09 to 2.68) | <0.001 | 1.06 (0.95 to 1.18) | 0.30 | 1.15 (1.04 to 1.28) | <0.01 |
| Other | 1.43 (1.18 to 1.73) | <0.001 | 2.93 (2.39 to 3.60) | <0.001 | 1.04 (0.85 to 1.26) | 0.71 | 1.17 (0.95 to 1.45) | 0.15 |
| eGFR per 5 ml/min per 1.73 m2 | 1.15 (1.13 to 1.17) | <0.001 | 1.08 (1.07 to 1.10) | <0.001 | 1.09 (1.07 to 1.11) | <0.001 | 1.10 (1.09 to 1.12) | <0.001 |
| Albumin concentration, g/dl | ||||||||
| <2.5 | 1.54 (1.38 to 1.72) | <0.001 | 1.36 (1.25 to 1.49) | <0.001 | 1.48 (1.33 to 1.65) | <0.001 | 1.38 (1.25 to 1.51) | <0.001 |
| 2.5 to < 3.0 | 1.36 (1.23 to 1.50) | <0.001 | 1.28 (1.18 to 1.40) | <0.001 | 1.32 (1.18 to 1.46) | <0.001 | 1.28 (1.17 to 1.41) | <0.001 |
| 3.0 to < 3.5 | 1.27 (1.14 to 1.41) | <0.001 | 1.15 (1.05 to 1.25) | 0.002 | 1.28 (1.17 to 1.40) | <0.001 | 1.17 (1.08 to 1.28) | <0.001 |
| 3.5 to < 4.0 | 1.08 (0.98 to 1.20) | 0.13 | 1.11 (1.02 to 1.21) | 0.02 | 1.21 (1.10 to 1.33) | <0.001 | 1.05 (0.96 to 1.16) | 0.27 |
| ≥4 | Reference | Reference | Reference | Reference | ||||
| Tobacco use, current smoker | 0.91 (0.83 to 0.99) | 0.02 | 0.96 (0.89 to 1.04) | 0.28 | 1.15 (1.06 to 1.25) | <0.001 | 0.91 (0.84 to 0.99) | 0.03 |
| Alcohol dependence | 1.02 (0.85 to 1.21) | 0.86 | 1.05 (0.90 to 1.22) | 0.54 | 0.84 (0.70 to 1.01) | 0.06 | 1.24 (1.04 to 1.48) | 0.02 |
| Drug dependence | 1.14 (0.93 to 1.40) | 0.21 | 1.20 (1.03 to 1.40) | 0.02 | 1.45 (1.20 to 1.75) | <0.001 | 1.30 (1.08 to 1.57) | <0.01 |
| Residence in care facility | 1.76 (1.64 to 1.89) | <0.001 | 1.65 (1.54 to 1.76) | <0.001 | 1.15 (1.06 to 1.25) | <0.001 | 1.43 (1.32 to 1.53) | <0.001 |
| Nephrology care before dialysis initiation, mo | ||||||||
| <6 | 1.08 (1.00 to 1.17) | 0.06 | 1.07 (1.00 to 1.16) | 0.06 | 1.04 (0.96 to 1.12) | 0.35 | 1.02 (0.95 to 1.10) | 0.55 |
| 6–12 | 1.09 (1.02 to 1.16) | <0.01 | 1.07 (1.01 to 1.13) | 0.03 | 1.05 (0.99 to 1.11) | 0.13 | 1.00 (0.95 to 1.06) | 0.92 |
| ≥12 | Reference | Reference | Reference | Reference | ||||
| None | 1.24 (1.17 to 1.33) | <0.001 | 1.21 (1.14 to 1.28) | <0.001 | 1.03 (0.97 to 1.10) | 0.30 | 1.04 (0.98 to 1.10) | 0.18 |
| Unknown | 1.30 (1.20 to 1.40) | <0.001 | 1.25 (1.16 to 1.34) | <0.001 | 1.07 (0.99 to 1.16) | 0.09 | 1.21 (1.12 to 1.31) | <0.001 |
| RUCA | ||||||||
| Urban | Reference | Reference | Reference | Reference | ||||
| Large rural | 1.01 (0.94 to 1.09) | 0.76 | 0.89 (0.83 to 0.95) | <0.001 | 1.02 (0.95 to 1.09) | 0.62 | 0.91 (0.85 to 0.97) | <0.01 |
| Small rural | 0.95 (0.86 to 1.04) | 0.24 | 0.91 (0.83 to 1.00) | 0.04 | 1.06 (0.97 to 1.16) | 0.18 | 0.87 (0.79 to 0.95) | 0.003 |
| Isolated small rural | 0.93 (0.83 to 1.03) | 0.15 | 0.92 (0.83 to 1.02) | 0.10 | 1.01 (0.91 to 1.12) | 0.88 | 0.81 (0.73 to 0.90) | <0.001 |
| ESRD network | ||||||||
| 1 | 0.78 (0.64 to 0.95) | 0.01 | 1.13 (0.93 to 1.38) | 0.21 | 1.36 (1.11 to 1.65) | 0.002 | 1.46 (1.22 to 1.76) | <0.001 |
| 2 | 1.16 (0.94 to 1.43) | 0.16 | 1.22 (1.01 to 1.47) | 0.04 | 1.00 (0.82 to 1.23) | 0.97 | 1.17 (0.97 to 1.41) | 0.10 |
| 3 | 1.10 (0.88 to 1.39) | 0.40 | 1.37 (1.11 to 1.68) | 0.003 | 1.13 (0.89 to 1.42) | 0.32 | 1.44 (1.19 to 1.76) | <0.001 |
| 4 | 1.05 (0.87 to 1.28) | 0.60 | 1.26 (1.04 to 1.53) | 0.02 | 1.11 (0.91 to 1.35) | 0.30 | 1.15 (0.97 to 1.37) | 0.12 |
| 5 | 1.19 (0.99 to 1.43) | 0.06 | 1.35 (1.13 to 1.60) | <0.001 | 1.34 (1.11 to 1.61) | 0.002 | 1.27 (1.07 to 1.51) | <0.01 |
| 6 | 1.07 (0.90 to 1.28) | 0.41 | 1.47 (1.25 to 1.73) | <0.001 | 1.30 (1.09 to 1.55) | 0.004 | 1.18 (1.00 to 1.38) | 0.05 |
| 7 | 1.15 (0.97 to 1.37) | 0.11 | 1.85 (1.56 to 2.19) | <0.001 | 1.01 (0.84 to 1.22) | 0.91 | 1.39 (1.18 to 1.64) | <0.001 |
| 8 | 1.02 (0.85 to 1.22) | 0.83 | 1.30 (1.09 to 1.54) | 0.003 | 1.29 (1.07 to 1.56) | <0.01 | 1.23 (1.04 to 1.46) | 0.02 |
| 9 | 1.05 (0.88 to 1.25) | 0.58 | 1.26 (1.06 to 1.50) | <0.01 | 1.33 (1.11 to 1.59) | 0.002 | 1.22 (1.04 to 1.44) | 0.02 |
| 10 | 1.08 (0.89 to 1.30) | 0.45 | 1.13 (0.93 to 1.36) | 0.22 | 1.39 (1.15 to 1.69) | <0.001 | 1.32 (1.10 to 1.58) | 0.003 |
| 11 | 1.06 (0.89 to 1.27) | 0.52 | 1.36 (1.14 to 1.62) | <0.001 | 1.07 (0.89 to 1.30) | 0.47 | 1.10 (0.93 to 1.31) | 0.27 |
| 12 | 0.86 (0.70 to 1.04) | 0.12 | 1.19 (0.99 to 1.43) | 0.07 | 1.32 (1.09 to 1.62) | <0.01 | 1.23 (1.03 to 1.47) | 0.02 |
| 13 | 1.18 (0.98 to 1.42) | 0.08 | 1.49 (1.25 to 1.77) | <0.001 | 1.33 (1.10 to 1.62) | 0.003 | 1.18 (0.99 to 1.41) | 0.06 |
| 14 | 0.96 (0.81 to 1.15) | 0.67 | 1.24 (1.06 to 1.47) | <0.01 | 1.16 (0.97 to 1.39) | 0.11 | 1.19 (1.01 to 1.39) | 0.04 |
| 15 | 0.87 (0.71 to 1.05) | 0.15 | 1.24 (1.03 to 1.50) | 0.02 | 1.21 (1.00 to 1.47) | 0.05 | 1.11 (0.92 to 1.34) | 0.26 |
| 16 | Reference | Reference | Reference | Reference | ||||
| 17 | 1.09 (0.90 to 1.31) | 0.39 | 1.01 (0.83 to 1.22) | 0.93 | 1.24 (1.02 to 1.50) | 0.03 | 1.09 (0.90 to 1.31) | 0.38 |
| 18 | 1.37 (1.14 to 1.64) | <0.001 | 1.13 (0.95 to 1.34) | 0.18 | 1.07 (0.88 to 1.30) | 0.50 | 1.10 (0.92 to 1.31) | 0.28 |
| Adults ≥25 yrs old who are high school graduates or higher, % | ||||||||
| <50 | Reference | Reference | Reference | Reference | ||||
| 50–75 | 0.95 (0.79 to 1.13) | 0.55 | 1.17 (0.98 to 1.41) | 0.09 | 0.93 (0.77 to 1.13) | 0.48 | 1.04 (0.88 to 1.23) | 0.66 |
| >75 | 0.89 (0.74 to 1.08) | 0.24 | 1.17 (0.97 to 1.41) | 0.11 | 0.90 (0.74 to 1.10) | 0.30 | 1.04 (0.87 to 1.24) | 0.69 |
| All people below poverty in the past 12 mo, % | ||||||||
| <5 | Reference | Reference | Reference | Reference | ||||
| 5–9.9 | 0.97 (0.88 to 1.07) | 0.51 | 0.98 (0.90 to 1.08) | 0.70 | 1.03 (0.94 to 1.13) | 0.55 | 0.97 (0.89 to 1.06) | 0.53 |
| 10–14.9 | 0.96 (0.87 to 1.06) | 0.47 | 0.99 (0.90 to 1.08) | 0.76 | 1.03 (0.94 to 1.13) | 0.55 | 0.98 (0.89 to 1.06) | 0.58 |
| 15–19.9 | 0.97 (0.88 to 1.07) | 0.54 | 0.99 (0.90 to 1.09) | 0.84 | 1.05 (0.95 to 1.15) | 0.36 | 1.02 (0.93 to 1.12) | 0.70 |
| 20–24.9 | 0.99 (0.89 to 1.10) | 0.90 | 0.99 (0.90 to 1.09) | 0.86 | 1.12 (1.01 to 1.25) | 0.03 | 1.01 (0.91 to 1.11) | 0.85 |
| ≥25 | 0.98 (0.88 to 1.10) | 0.77 | 1.06 (0.96 to 1.18) | 0.23 | 1.10 (0.99 to 1.22) | 0.09 | 1.02 (0.93 to 1.13) | 0.65 |
| Volume, no. of facility patients | ||||||||
| ≤41 | Reference | Reference | Reference | Reference | ||||
| 42–63 | 1.03 (0.95 to 1.13) | 0.47 | 1.02 (0.94 to 1.10) | 0.65 | 1.03 (0.95 to 1.11) | 0.48 | 1.09 (1.01 to 1.17) | 0.03 |
| 64–91 | 1.02 (0.93 to 1.12) | 0.68 | 1.05 (0.97 to 1.14) | 0.23 | 1.12 (1.03 to 1.22) | <0.01 | 1.07 (0.99 to 1.16) | 0.07 |
| >91 | 0.96 (0.86 to 1.08) | 0.50 | 1.06 (0.96 to 1.18) | 0.22 | 1.16 (1.05 to 1.28) | 0.003 | 1.08 (0.99 to 1.19) | 0.10 |
| Total no. of nurses and PCTs per five staff higher | 1.00 (0.98 to 1.03) | 0.83 | 0.98 (0.96 to 1.01) | 0.20 | 0.97 (0.95 to 0.99) | 0.01 | 0.98 (0.96 to 1.00) | 0.12 |
| Staff composition per 10% higher nurse composition | 1.00 (0.98 to 1.01) | 0.72 | 0.98 (0.96 to 0.99) | 0.004 | 1.00 (0.98 to 1.02) | 0.97 | 1.00 (0.98 to 1.02) | 0.98 |
| Home program volume | ||||||||
| 0/None | Reference | Reference | Reference | Reference | ||||
| 1–10 | 1.04 (0.98 to 1.11) | 0.18 | 1.06 (1.00 to 1.13) | 0.04 | 1.07 (1.01 to 1.13) | 0.03 | 1.07 (1.01 to 1.14) | 0.02 |
| 11–25 | 0.99 (0.92 to 1.07) | 0.84 | 1.03 (0.95 to 1.11) | 0.48 | 1.03 (0.96 to 1.10) | 0.45 | 1.04 (0.98 to 1.11) | 0.20 |
| ≥26 | 0.98 (0.88 to 1.08) | 0.66 | 1.00 (0.91 to 1.10) | 0.95 | 0.93 (0.84 to 1.01) | 0.10 | 1.01 (0.92 to 1.10) | 0.82 |
RR, rate ratio; 95% CI, 95% confidence interval; COPD, chronic obstructive pulmonary disease; AV, arteriovenous; RUCA, rural-urban commuting area; HS, high school; PCT, patient care technician.