Table 2.
Observed Patient and Hospital Characteristics and Outcomes Among Propensity-Matched Cohort
| Characteristics | Macrolide Before Cephalosporin | Cephalosporin Before Macrolide | P Valuea |
|---|---|---|---|
| N (%) | N (%) | ||
| 527 (50) | 527 (50) | ||
| Age, median (IQR), yearsb | 68 (53–81) | 70 (54–81) | .61 |
| Gender | .90 | ||
| Male | 240 (45.5) | 238 (45.2) | |
| Female | 287 (54.5) | 289 (54.8) | |
| Race/Ethnicity | .63 | ||
| White | 404 (76.7) | 415 (78.7) | |
| Black | 79 (15) | 79 (15) | |
| Hispanic | 14 (2.7) | 11 (2.1) | |
| Other | 30 (5.7) | 22 (4.2) | |
| Insurance Payer | .03 | ||
| Medicare | 197 (37.4) | 237 (45) | |
| Medicaid | 26 (4.9) | 28 (5.3) | |
| Other | 304 (57.7) | 262 (49.7) | |
| LAPS, median (IQR)b | 40 (27–53) | 40 (30–55) | .22 |
| Principal Diagnosis | .28 | ||
| Pneumonia | 430 (81.6) | 415 (78.7) | |
| ARF | 26 (4.9) | 38 (7.2) | |
| Sepsis | 71 (13.5) | 74 (14) | |
| Type of Pneumonia | .290 | ||
| CAP | 351 (66.6) | 367 (69.6) | |
| HCAP | 176 (33.4) | 160 (30.4) | |
| Gagne combined score, median (IQR)b | 2 (1–3) | 2 (0–4) | .68 |
| Comorbiditiesc | |||
| Chronic pulmonary disease | 251 (47.6) | 224 (42.5) | .09 |
| Hypertension | 231 (43.8) | 240 (45.5) | .58 |
| Smoking | 151 (28.7) | 154 (29.2) | .84 |
| Diabetes | 151 (28.7) | 150 (28.5) | .95 |
| Congestive heart failure | 117 (22.2) | 111 (21.1) | .65 |
| Chronic blood loss anemia/deficiency anemias | 110 (20.9) | 111 (21.1) | .94 |
| Renal failure | 75 (14.2) | 72 (13.7) | .79 |
| Depression/psychoses | 65 (12.3) | 69 (13.1) | .71 |
| Other neurological disorders | 62 (11.8) | 72 (13.7) | .36 |
| Hypothyroidism | 53 (10.1) | 59 (11.2) | .55 |
| Obesity | 54 (10.2) | 54 (10.2) | 1 |
| Valvular disease | 37 (7.0) | 30 (5.7) | .38 |
| Metastatic cancer/solid tumor without metastasis | 34 (6.5) | 37 (7.0) | .71 |
| Weight loss | 33 (6.3) | 26 (4.9) | .35 |
| Pulmonary circulation disease | 27 (5.1) | 27 (5.1) | 1 |
| Prior Year Receipt of IMV | |||
| 0 | 519 (98.5) | 514 (97.5) | |
| 1 time | 8 (1.5) | 10 (1.9) | |
| 2 or more times | 3 (0.6) | ||
| Prior Year Receipt of NIV | |||
| 0 | 519 (98.5) | 520 (98.7) | |
| 1 time | 5 (0.9) | 5 (0.9) | |
| 2 or more times | 3 (0.6) | 2 (0.4) | |
| Prior Year Admissions | .71 | ||
| 0 | 305 (57.9) | 298 (56.5) | |
| 1 time | 110 (20.9) | 121 (23) | |
| 2 or more times | 112 (21.3) | 108 (20.5) | |
| Initial Care Venue | .46 | ||
| Ward | 458 (86.9) | 452 (85.8) | |
| Intensive care unit | 51 (9.7) | 49 (9.3) | |
| Intermediate care | 18 (3.4) | 26 (4.9) | |
| Vasopressors (before 1st abx or ≤12 hrs after 1st abx) | 22 (4.2) | 23 (4.4) | .88 |
| NIV (before 1st abx or ≤12 hrs after 1st abx) | 15 (2.8) | 18 (3.4) | .60 |
| IMV (before 1st abx or ≤12 hrs after 1st abx) | 26 (4.9) | 22 (4.2) | .55 |
| Hospital Region | .02 | ||
| Midwest | 106 (20.1) | 83 (15.7) | |
| Northeast | 208 (39.5) | 254 (48.2) | |
| South | 165 (31.3) | 157 (29.8) | |
| West | 48 (9.1) | 33 (6.3) | |
| Hospital Size | .05 | ||
| 6–199 beds | 143 (27.1) | 110 (20.9) | |
| 200–499 beds | 286 (54.3) | 319 (60.5) | |
| 500 and more beds | 98 (18.6) | 98 (18.6) | |
| Hospital Teaching Status | .46 | ||
| Nonteaching | 160 (30.4) | 149 (28.3) | |
| Teaching | 367 (69.6) | 378 (71.7) | |
| Outcomesc | |||
| Clinical Deterioration | |||
| Late NIV | 3 (0.6) | 5 (1) | .48 |
| Late IMV | 12 (2.4) | 17 (3.4) | .34 |
| Late vasopressors | 23 (4.6) | 22 (4.4) | .88 |
| In-hospital mortality | 22 (4.2) | 29 (5.5) | .31 |
| In-hospital mortality/hospice discharge | 33 (6.3) | 49 (9.3) | .06 |
| LOS, median (IQR), hours | 101.5 (70.0–170.1) | 109.5 (67.2–166.0) | .09 |
| Readmission within 30 days (survivors) | 65 (12.9) | 53 (10.6) | .27 |
| Discharge disposition (among survivors, nonhospice discharges, n = 972) | .17 | ||
| Home/home-health | 369 (74.7) | 339 (70.9) | |
| SNF/ICF | 116 (23.5) | 125 (26.1) | |
| Other | 9 (1.8) | 14 (2.9) | |
Abbreviations: abx, antibiotic; ARF, acute respiratory failure; CAP, community-acquired pneumonia; HCAP, healthcare-associated pneumonia; ICF, intermediate care facility; IMV, invasive mechanical ventilation; IQR, interquartile range; LAPS, Laboratory Acute Physiology Score; LOS, length of stay; NIV, noninvasive mechanical ventilation; SNF, skilled nursing facility.
aχ2 test.
bKruskal-Wallis test.
cComorbidities with at least 5% prevalence are presented.
c P values account for propensity score matching.