Table 6.
Direct and Indirect effects of autoimmune disease on 30-day mortality, mediated through immunomodulation medication use
| Mediation analysis of the effect of autoimmune disease on 30-day mortality | Sepsis cohort | Septic shock cohort | ||
|---|---|---|---|---|
| OR (95% CI) | P-value | OR (95% CI) | P value | |
| All potential confounders adjusteda | ||||
| Indirect effect | 1.07 (1.01–1.13) | 0.020 | 1.06 (0.99–1.13) | 0.112 |
| Direct effect | 0.78 (0.61–0.98) | 0.004 | 0.75 (0.57–0.98) | 0.037 |
| SOFA adjusted | ||||
| Indirect effect | 1.06 (1.00–1.11) | 0.033 | 1.04 (0.99–1.12) | 0.130 |
| Direct effect | 0.75 (0.60–0.93) | 0.011 | 0.69 (0.53–0.90) | 0.006 |
Sepsis cohort—ICU patients with sepsis defined with Martin criteria. Septic shock cohort—ICU patients with sepsis defined by Martin criteria and three consecutive mean arterial blood pressure readings below 65 mmHg in a 30-min period or at least one dose of vasopressors during the ICU stay
OR odds ratio, CI confidence interval, DMARD disease-modifying antirheumatic drug
aOR adjusted for age, sex, race, SOFA score at ICU admission, Elixhauser comorbidity index, pre-admission chronic DMARD or prednisone use, ICU care unit, documented bacteremia, and infection site