Table. Association of Patient and Hospital-Level Characteristics With Receiving an Endotracheal Aspirate Culture (EAC) and Antibiotic DOT.
| Variable | Patients with mechanical ventilation, No. (%) | Odds ratio (95% CI) of receiving EAC | Odds ratio (95% CI) of receiving antibiotics | |||
|---|---|---|---|---|---|---|
| Without EAC (n = 112 081) | With EAC (n = 40 051) | Unadjusted | Adjusted | Unadjusted | Adjusted | |
| Case-mix index, median (IQR) | 6.34 (2.91-14.36) | 8.05 (3.89-16.45) | 1.03 (1.02-1.03)a | 1.03 (1.02-1.03)a | 1.17 (1.17-1.17)a | 1.11 (1.11-1.12)a |
| Geographic location | ||||||
| Midwest | 37 039 (33) | 12 539 (31.3) | 0.67 (0.65-0.69)a | 0.83 (0.42-1.62) | 0.58 (0.56-0.60)a | 1.01 (0.73-1.38) |
| Northeast | 24 269 (21.7) | 5875 (14.7) | 0.48 (0.46-0.50)a | 0.42 (0.19-0.91) | 0.56 (0.54-0.59)a | 0.83 (0.57-1.20) |
| South | 33 492 (29.9) | 12 908 (32.2) | 0.76 (0.74-0.79)a | 0.81 (0.42-1.56) | 1.02 (0.98-1.07) | 1.11 (0.81-1.51) |
| West | 17 281 (15.4) | 8729 (21.8) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Age, y | ||||||
| <1 | 65 256 (58.2) | 17 450 (43.6) | 0.63 (0.61-0.65)a | 0.61 (0.59-0.64)a | 1.54 (1.48-1.60)a | 1.27 (1.21-1.33)a |
| 1-4 | 20 228 (18) | 10 761 (26.9) | 1.25 (1.20-1.30)a | 1.31 (1.25-1.36)a | 1.05 (1.01-1.10)a | 1.09 (1.04-1.14)a |
| 5-11 | 14 087 (12.6) | 6518 (16.3) | 1.09 (1.04-1.14)a | 1.05 (1.00-1.10) | 1.24 (1.18-1.30)a | 1.25 (1.18-1.32)a |
| 12-18 | 12 510 (11.2) | 5322 (13.3) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Sex | ||||||
| Male | 63 336 (56.5) | 22 414 (56) | 0.98 (0.96-1.00) | 1.01 (0.98-1.03) | 1.00 (0.97-1.02) | 1.01 (0.98-1.04) |
| Female | 48 745 (43.5) | 17 637 (44) | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| Race and ethnicity | ||||||
| Asian | 3789 (3.4) | 1167 (2.9) | 0.92 (0.86-0.99) | 1.04 (0.97-1.12) | 1.07 (0.99-1.15) | 0.95 (0.87-1.03) |
| Hispanic | 17 176 (15.3) | 6919 (17.3) | 1.21 (1.17-1.24)a | 1.08 (1.04-1.12)a | 1.34 (1.29-1.40)a | 0.98 (0.94-1.03) |
| Non-Hispanic Black | 21 688 (19.4) | 8446 (21.1) | 1.16 (1.13-1.20)a | 1.20 (1.16-1.24)a | 0.87 (0.84-0.90)a | 0.80 (0.77-0.83)a |
| Non-Hispanic White | 53 575 (47.8) | 17 910 (44.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Otherb | 15 853 (14.1) | 5609 (14) | 1.06 (1.02-1.10)a | 1.09 (1.05-1.14)a | 1.03 (0.99-1.07) | 0.98 (0.94-1.03) |
| Any CCC | 84 029 (75) | 34 626 (86.5) | 2.13 (2.06-2.20)a | 0.95 (0.91-0.99)a | 3.66 (3.56-3.76)a | 1.55 (1.50-1.60)a |
| Cumulative ventilator-days | ||||||
| 1-3 | 72 351 (64.6) | 7993 (20) | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| 4-14 | 31 176 (27.8) | 18 763 (46.8) | 5.45 (5.29-5.61)a | 2.60 (2.50-2.71)a | 3.80 (3.68-3.93)a | 1.88 (1.81-1.95)a |
| >14 | 8554 (7.6) | 13 295 (33.2) | 14.07 (13.58-14.58)a | 6.81 (6.40-7.24)a | 11.01 (10.25-11.83)a | 1.87 (1.72-2.03)a |
| No. of ventilation episodes | ||||||
| 1 | 95 594 (85.3) | 28 662 (71.6) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| ≥2 | 16 487 (14.7) | 11 389 (28.4) | 2.30 (2.24-2.37)a | 0.86 (0.83-0.90)a | 3.81 (3.63-3.99)a | 1.25 (1.18-1.32)a |
| Receiving EAC | ||||||
| No | NA | NA | NA | NA | 1 [Reference] | 1 [Reference] |
| Yes | NA | NA | NA | NA | 4.68 (4.49-4.88)a | 2.87 (2.74-3.01)a |
Abbreviations: CCC, complex chronic condition; EAC, endotracheal aspirate; NA, not applicable.
a
Statistical significance defined as P < .001.
b
Including American Indian, Alaskan Native, Native Hawaiian Pacific Islander, and other meaning all other race and ethnicity groups including those records that have multiple race groups indicated on their patient record.