TABLE 1.
Bivariate comparisons of demographic and clinical characteristics between nephrotoxic and non-nephrotoxic patientsa
| Characteristic | Value for patients |
P value | |
|---|---|---|---|
| Non-nephrotoxic (n = 303) | Nephrotoxic (n = 20) | ||
| Demographics | |||
| Age (yrs), mean (SD) | 61.5 (16.5) | 64.2 (21.3) | 0.593 |
| Male, no. (%) | 152 (50.2) | 15 (75.0) | 0.031 |
| Race, no. (%) | 0.636 | ||
| African American | 228 (75.2) | 13 (65.0) | |
| Caucasian | 56 (18.5) | 6 (30.0) | |
| Asian | 2 (0.7) | 0 | |
| Other/unknown | 17 (5.6) | 1 (5.0) | |
| Selected comorbidities | |||
| Renal disease, no. (%) | 50 (16.5) | 10 (50.0) | <0.001 |
| Liver disease, no. (%) | 26 (8.6) | 5 (25.0) | 0.016 |
| Heart failure, no. (%) | 107 (35.3) | 14 (70.0) | 0.002 |
| Diabetes, no. (%) | 107 (35.3) | 9 (45.0) | 0.382 |
| Peripheral vascular disease, no. (%) | 38 (12.5) | 4 (20.0) | 0.337 |
| Hypertension, no. (%) | 229 (75.6) | 16 (80.0) | 0.792 |
| Obesity, no. (%) | 54 (17.8) | 2 (10.0) | 0.546 |
| Elixhauser comorbidity index, median (IQR) | 5 (3–7) | 7.5 (5.25–8.75) | <0.001 |
| Clinical data | |||
| Baseline SCrb (mg/dl), median (IQR) | 0.88 (0.69–1.18) | 0.95 (0.87–1.22) | 0.164 |
| APACHE II score,b median (IQR) | 13 (9–18) | 20.5 (12.75–31.25) | 0.001 |
| Concomitant nephrotoxin,d no. (%) | 183 (60.4) | 16 (80.0) | 0.098 |
| Intravenous contrast dye, no. (%) | 49 (16.2) | 9 (45.0) | 0.001 |
| Furosemide, no. (%) | 119 (39.3) | 15 (75.0) | 0.002 |
| Lisinopril, no. (%) | 78 (25.7) | 6 (30.0) | 0.674 |
| Aminoglycoside, no. (%) | 23 (7.6) | 2 (10.0) | 0.660 |
| Vancomycin treatment data | |||
| Vancomycin indication,c no. (%) | 0.777 | ||
| Bacteremia | 172 (56.8) | 12 (60.0) | |
| Pneumonia | 131 (43.2) | 8 (40.0) | |
| AUC monitoring, no. (%) | 160 (52.8) | 9 (45.0) | 0.498 |
| Total daily dose from 0 to 48 h (mg), median (IQR) | 5,000 (4,000–6,500) | 4,625 (3,062–7,375) | 0.593 |
| Total daily dose from 0 to 24 h (mg), median (IQR) | 3,000 (1,250–4,000) | 2,625 (2,312–4,875) | 0.741 |
| Total daily dose from 24 to 48 h (mg), median (IQR) | 2,000 (1,250–3,000) | 1,625 (1,000–2,500) | 0.257 |
| Vancomycin duration (days), median (IQR) | 6 (5–8) | 6.5 (5–9.75) | 0.163 |
| AUC0–48 (mg · h/liter), median (IQR) | 1,162 (913–1,462) | 1,413 (1,220–1,600) | 0.031 |
| AUC0–24 (mg · h/liter), median (IQR) | 569 (413–735) | 700 (547–821) | 0.058 |
| AUC24–48 (mg · h/liter), median (IQR) | 577 (459–731) | 719 (568–853) | 0.029 |
| Cmin24 (mg/liter), median (IQR) | 11 (7.7–14.4) | 13 (9.5–18.4) | 0.089 |
| Cmin48 (mg/liter), median (IQR) | 13.5 (9.3–17.0) | 16.1 (11.2–21.5) | 0.055 |
| AUC0–48 of ≥1,218 mg · h/liter, no. (%) | 138 (45.5) | 16 (80.0) | 0.003 |
| AUC0–24 of ≥677 mg · h/liter, no. (%) | 101 (33.3) | 13 (65.0) | 0.004 |
| AUC24–48 of ≥683 mg · h/liter, no. (%) | 92 (30.4) | 12 (60.0) | 0.006 |
| Cmin24 of ≥18.8 mg/liter, no. (%) | 27 (8.9) | 5 (25.0) | 0.020 |
a
Abbreviations: APACHE, acute physiology and chronic health evaluation; SCr, serum creatinine.
b
At time of 1st vancomycin dose.
c
Indication per physician order for vancomycin.
d
Seventy-two hours before initial vancomycin dose to 72 h after last vancomycin dose.