Table 6.
Independent relationships with mortality in critically ill patients with intra-abdominal infection
| Variable | Model with source control achievement* OR (95% CI) |
Model without source control achievement** OR (95% CI) |
|---|---|---|
| Setting of infection acquisition | ||
| Community-acquired infection | Reference | Reference |
| Early onset hospital-acquired infection (≤ 7 days) | 1.15 (0.84–1.58) | 1.18 (0.88–1.59) |
| Late-onset hospital-acquired infection (> 7 days) | 1.76 (1.34–2.32) | 1.76 (1.36–2.30) |
| Anatomical disruption | ||
| No anatomical barrier disruption | Reference | Reference |
| Anatomical disruption with localized peritonitis | 1.28 (0.95–1.75) | 1.26 (0.95–1.69) |
| Anatomical disruption with diffuse peritonitis | 1.99 (1.49–2.67) | 2.04 (1.55–2.70) |
| Severity of disease expression | ||
| Infection | Reference | Reference |
| Sepsis | 2.44 (1.37–4.66) | 2.28 (1.31–4.28) |
| Septic shock | 5.22 (2.91–10) | 4.93 (2.80–9.30) |
| Age (per year increase) | 1.03 (1.02–1.04) | 1.03 (1.03–1.04) |
| Underlying conditions | ||
| Malnutrition (body mass index < 20) | 2.07 (1.34–3.17) | 2.15 (1.43–3.21) |
| Diabetes mellitus | 1.31 (0.99–1.73) | 1.32 (1.01–1.72) |
| Liver failure | 2.03 (1.23–3.33) | 2.50 (1.55–4.02) |
| Congestive heart failure | 1.86 (1.24–2.81) | 1.92 (1.31–2.81) |
| Empiric antimicrobial coverage | ||
| Anti-MRSA agent | 0.77 (0.59–1) | 0.77 (0.59–0.98) |
| Double anaerobe coverage | – | 1.28 (0.97–1.71) |
| Source control achievement at day 7 | ||
| Success | Reference | – |
| Failure, persistent signs of inflammation | 4.85 (3.79–6.22) | – |
| Failure, additional intervention required following initial approach | 1.93 (1.41–2.65) | – |
The variable “antimicrobial resistance” defined as either MRSA, vancomycin-resistant enterococci (VRE), or difficult-to-treat resistant Gram-negative bacteria did not achieve the final regression model. Supplement-9 reports the results of the logistic regression models with antibiotic resistance defined as either MRSA, VRE, ESBL-producing, or carbapenem-resistant Gram-negative bacteria. In these logistic regression models, antibiotic resistance was associated with increased risk of mortality, while other covariates remained stable
OR odds ratio, CI confidence interval, MRSA methicillin-resistant Staphylococcus aureus
*Area under the receiver-operating curve characteristic: 0.778; **Area under the receiver-operating curve characteristic: 0.689