Table 3.
Predisposition, infection, response, and organ failure (PIRO) characteristics of admissions stratified by admission status
| Variable | At risk, N = 53 | Limited organ failure, N = 1151 | Multiple-organ failure, N = 167 | P value |
|---|---|---|---|---|
| Predisposition | ||||
| Age (years) | 63 (48–73) | 63 (53–71) | 63 (52–71) | 0.90 |
| Male gender | 61 (61) | 709 (61) | 82 (62) | 0.98 |
| Chronic comorbidities | ||||
| Diabetes mellitus | 26 (26) | 217 (19) | 24 (18) | 0.19 |
| Cardiovascular diseasea | 28 (28) | 318 (27) | 30 (23) | 0.49 |
| Immunodeficiencyb | 33 (33) | 316 (27) | 41 (31) | 0.33 |
| Renal insufficiencyc | 23 (23) | 192 (16) | 20 (15) | 0.21 |
| Respiratory insufficiencyd | 15 (15) | 171 (15) | 24 (18) | 0.59 |
| Admission type, medical | 78 (78) | 853 (73) | 103 (77) | 0.22 |
| Insult | ||||
| Source (hospital-acquired) | 42 (42) | 514 (44) | 65 (49) | 0.51 |
| Site/organ system | 0.036 | |||
| Pulmonary | 68 (68) | 676 (58) | 61 (46) | |
| Abdomen | 5 (5) | 125 (11) | 20 (15) | |
| Urinary tract | 6 (6) | 67 (6) | 11 (8) | |
| Other or unknown | 21 (21) | 298 (26) | 41 (31) | |
| Response | ||||
| SIRS criteriae | ||||
| Temperature | 53 (53) | 683 (59) | 92 (69) | 0.027 |
| Leukocytes | 65 (65) | 839 (72) | 93 (70) | 0.32 |
| Respiratory rate | 86 (86) | 1122 (96) | 130 (98) | < 0.001 |
| Heart rate | 75 (75) | 939 (81) | 122 (92) | 0.002 |
| C-reactive protein (mg/L) | 118 (75–209) | 189 (101–296) | 225 (123–293) | 0.015 |
| Lactate (mmol/L) | 2.0 (1.3–2.9) | 2.7 (1.7–4.5) | 6.2 (4.1–10.7) | < 0.001 |
| Organ dysfunction | ||||
| SOFA score at admission | 5 (4–7) | 8 (7–10) | 12 (11–15) | < 0.001 |
| APACHE IV score | 70 (60–87) | 84 (69–102) | 112 (95–130) | < 0.001 |
| Outcome | ||||
| ICU case fatality | 5 (9) | 180 (16) | 67 (40) | < 0.001 |
| ICU length of stay (days) | 5 (3–12) | 7 (3–12) | 10 (4–18) | < 0.001 |
Data are numbers (percentage) or median (inter-quartile range)
Abbreviations: APACHE Acute Physiology and Chronic Health Evaluation, ICU intensive care unit, SIRS systemic inflammatory response syndrome
aCardiovascular disease was defined as cerebrovascular disease or chronic cardiovascular insufficiency (New York Heart Association class 4), chronic congestive heart failure (ejection fraction < 30%), or peripheral vascular disease (intermittent claudication, patients with percutaneous transluminal angioplasty or bypass for arterial insufficiency)
bImmunodeficiency was defined as having acquired immune deficiency syndrome, the use of corticosteroids in high doses (equivalent to prednisolone of > 75 mg/day for at least 1 week), current use of immunosuppressive drugs, current use of antineoplastic, drugs recent hematologic malignancy, or documented humoral or cellular deficiency
cRenal insufficiency was defined as chronic renal insufficiency (creatinine > 177 μmol/L) or chronic dialysis
dRespiratory insufficiency was defined as chronic obstructive pulmonary disease or chronic respiratory insufficiency with functional disabilities (chronic mechanical ventilation, oxygen use at home, or severe pulmonary hypertension)
eSystemic inflammatory response syndrome criteria were defined as temperature < 36.0 or > 38.0 °C during at least 2 and 1 h, respectively; white blood cell count < 4 or > 12 × 109/L or > 10% immature (band) forms; heart rate > 90/min during at least 1 h; respiratory rate > 20/min during at least 1 h, pCO2 < 32 mmHg, or mechanical ventilation