Table 3. Association of Type and Duration of Antimicrobial Exposure With Postoperative Acute Kidney Injury (AKI) and Clostridium difficile Infection.
| Variable | aOR (95% CI) |
|---|---|
| AKI (Cardiac Surgery)a | |
| Antimicrobial type | |
| β-Lactam | 1 [Reference] |
| Vancomycin + aminoglycoside | 1.24 (0.95-1.61) |
| Aminoglycoside | 0.60 (0.37-0.99) |
| Vancomycin | 1.17 (1.10-1.25) |
| Other | 1.07 (0.58-2.00) |
| Antimicrobial duration, h | |
| <24 | 1 [Reference] |
| 24-<48 | 1.03 (0.95-1.12) |
| 48-<72 | 1.22 (1.08-1.39) |
| ≥72 | 1.82 (1.54-2.16) |
| AKI (Noncardiac Surgery)b | |
| Antimicrobial type | |
| β-Lactam | 1 [Reference] |
| Vancomycin + aminoglycoside | 1.77 (1.42-2.20) |
| Aminoglycoside | 1.12 (0.90-1.38) |
| Vancomycin | 1.21 (1.13-1.30) |
| Other | 1.13 (0.98-1.29) |
| Antimicrobial duration, h | |
| <24 | 1 [Reference] |
| 24-<48 | 1.31 (1.21-1.42) |
| 48-<72 | 1.72 (1.47-2.01) |
| ≥72 | 1.79 (1.27-2.53) |
| C difficile Infectionc | |
| Antimicrobial type | |
| β-Lactam | 1 [Reference] |
| Vancomycin + aminoglycoside | 1.42 (0.81-2.48) |
| Aminoglycoside | 0.72 (0.37-1.41) |
| Vancomycin | 0.87 (0.72-1.05) |
| Other | 1.53 (1.07-2.19) |
| Antimicrobial duration, h | |
| <24 | 1 [Reference] |
| 24-<48 | 1.08 (0.89-1.31) |
| 48-<72 | 2.43 (1.80-3.27) |
| ≥72 | 3.65 (2.40-5.55) |
Abbreviation: aOR, adjusted odds ratio.
Model adjusted for age, sex, race, smoking status, diabetes, American Society of Anesthesiologists score less than 2, cardiopulmonary bypass pump time (quartiles), intraoperative blood transfusion (categorical; reference, none), receipt of perioperative nonsteroidal anti-inflammatory drugs and proton pump inhibitors, and facility median duration of surgical prophylaxis for cardiac procedures. Model C statistic, 0.64.
Model adjusted for age, sex, race, smoking status, diabetes, anesthesia type (categorical) and duration (categorical, quartiles), receipt of intraoperative blood transfusions (categorical; reference, none), receipt of nonsteroidal anti-inflammatory drugs and proton pump inhibitors, and facility median duration of surgical prophylaxis for noncardiac procedures only. Model C statistic, 0.66.
Model adjusted for age, sex, race, diabetes, smoking status, receipt of perioperative proton pump inhibitors, and facility median duration of surgical prophylaxis. Model C statistic, 0.65.