Table 1.
Patient Characteristics
| Characteristica | No. (%) | P Valueb | ||
|---|---|---|---|---|
| All Patients | 1-h Bundle Completed in 1 h | |||
| Yes | No | |||
| Patients, No. (%) | 1179 (100.0) | 294 (24.9) | 885 (75.1) | |
| Age | ||||
| ≤1 mo | 109 (9.2) | 28 (9.5) | 81 (9.2) | .72 |
| >1 mo-<1 y | 165 (14.0) | 40 (13.6) | 125 (14.1) | |
| 1-<2 y | 95 (8.1) | 27 (9.2) | 68 (7.7) | |
| 2-5 y | 185 (15.7) | 53 (18.0) | 132 (14.9) | |
| 6-11 y | 233 (19.8) | 55 (18.7) | 178 (20.1) | |
| 12-17 y | 392 (33.2) | 91 (31.0) | 301 (34.0) | |
| Male | 639 (54.2) | 161 (54.8) | 478 (54.0) | .82 |
| Race | ||||
| White | 551 (46.7) | 157 (53.4) | 394 (44.5) | .008 |
| Black | 255 (21.6) | 47 (16.0) | 208 (23.5) | |
| Other | 373 (31.6) | 90 (30.6) | 283 (32.0) | |
| Hispanic ethnicity | 235 (19.9) | 59 (20.1) | 176 (19.9) | .95 |
| Payer | ||||
| Medicare | 21 (1.8) | 1 (0.3) | 20 (2.3) | .17c |
| Medicaid | 509 (43.2) | 130 (44.2) | 379 (42.8) | |
| Private or HMO | 552 (46.8) | 138 (46.9) | 414 (46.8) | |
| Self-pay | 20 (1.7) | 7 (2.4) | 13 (1.5) | |
| Other | 77 (6.5) | 18 (6.1) | 59 (6.7) | |
| Comorbidities | ||||
| Malignancy | 153 (13.0) | 28 (9.5) | 125 (14.1) | .04 |
| Immunosuppressed | 269 (22.8) | 65 (22.1) | 204 (23.1) | .74 |
| Cardiopulmonary dysfunction | 143 (12.1) | 26 (8.8) | 117 (13.2) | .05 |
| Chronic renal failure or liver disease | 52 (4.4) | 7 (2.4) | 45 (5.1) | .05 |
| Diabetes | 37 (3.1) | 7 (2.4) | 30 (3.4) | .39 |
| No comorbidity | 525 (44.5) | 161 (54.8) | 364 (41.1) | .01 |
| Protocol initiation site | ||||
| Emergency department | 675 (57.3) | 204 (69.4) | 471 (53.2) | <.001 |
| Ward | 176 (14.9) | 33 (11.2) | 143 (16.2) | |
| Intensive care unit | 328 (27.8) | 57 (19.4) | 271 (30.6) | |
| Organ dysfunction at protocol initiation | ||||
| Platelet count <150 000/μL | 356 (30.2) | 71 (24.2) | 285 (32.2) | .009 |
| Altered mental status | 323 (27.4) | 100 (34.0) | 223 (25.2) | .003 |
| Acute respiratory failure requiring mechanical ventilation | 203 (17.2) | 36 (12.2) | 167 (18.9) | .009 |
| Septic shock | 811 (68.8) | 207 (70.4) | 604 (68.3) | .49 |
| Serum lactate, median (IQR), mmol/L | 2.1 (1.3-3.8) | 2.2 (1.4-4.1) | 2.1 (1.3-3.8) | .09d |
| Transferred from another facility | 225 (19.1) | 40 (13.6) | 185 (20.9) | .006 |
| Site of infection | ||||
| Urinary | 125 (10.6) | 29 (9.9) | 96 (10.8) | .002 |
| Respiratory | 373 (31.6) | 106 (36.1) | 267 (30.2) | |
| Gastrointestinal | 190 (16.1) | 38 (12.9) | 152 (17.2) | |
| Skin | 59 (5.0) | 16 (5.4) | 43 (4.9) | |
| Central nervous system | 26 (2.2) | 6 (2.0) | 20 (2.3) | |
| Other | 239 (20.3) | 75 (25.5) | 164 (18.5) | |
| Unknown | 167 (14.2) | 24 (8.2) | 143 (16.2) | |
| Type of pathogen | ||||
| Gram positive | 139 (11.8) | 47 (16.0) | 92 (10.4) | <.001 |
| Gram negative | 104 (8.8) | 27 (9.2) | 77 (8.7) | |
| Othere | 87 (7.4) | 4 (1.4) | 83 (9.4) | |
| None reported | 849 (72.0) | 216 (73.5) | 633 (71.5) | |
| Hospital with pediatric intensive care | 1031 (87.4) | 258 (87.8) | 773 (87.3) | .85 |
| Hospital length of stay, median (IQR), h | 235 (118-496) | 198 (101-358) | 244 (123-554) | <.001d |
| In-hospital death | 139 (11.8) | 22 (7.5) | 117 (13.2) | .008 |
Abbreviations: HMO, health maintenance organization; IQR, interquartile range.
a
No data were missing among individual bundle elements, transfer status, age, payer, place of protocol initiation, septic shock, site of infection, platelet count at protocol initiation, chronic renal disease or liver failure, diabetes, mechanical ventilation prior to protocol initiation, mortality, and length of stay.
b
P values are based on Pearson χ2 test unless otherwise noted.
c
P value based on Fisher exact test.
d
P value based on Wilcoxon rank-sum test.
e
Anaerobic bacteria, yeast, fungus, mixed pathogens, and viruses.