Table 1.
Clinical characteristics of the patients.
| Total (N = 147) |
Survivors at 28 Days (N = 128) |
Non-Survivors at 28 Days (N = 19) |
p-Value | |
|---|---|---|---|---|
| Age (years) | 69 ± 16 | 67 ± 16 | 78 ± 10 | 0.001 |
| Sex (F) | 59 (40.1%) | 50 (39.1%) | 9 (47.4%) | 0.62 |
| Pre-existing comorbidities | ||||
| Hypertension | 89 (60.5%) | 75 (58.6%) | 14 (73.7%) | 0.21 |
| Smoking | 31 (21.1%) | 25 (19.5%) | 6 (31.6%) | 0.45 |
| CAD | 30 (20.4%) | 25 (19.5%) | 5 (26.3%) | 0.49 |
| Recent (<3 months) hospital admission | 31 (21.1%) | 28 (21.9%) | 3 (15.8%) | 0.54 |
| Chronic steroids | 32 (21.8%) | 27 (21.1%) | 5 (26.3%) | 0.61 |
| Immunosuppression | 22 (15.0%) | 18 (14.2%) | 4 (23.5%) | 0.57 |
| HIV | 0 (0%) | - | - | - |
| Active solid cancer | 28 (19.0%) | 21 (16.4%) | 7 (36.8%) | 0.03 |
| Active hematologic malignancy | 16 (10.9%) | 13 (10.2%) | 3 (15.8%) | 0.44 |
| Chronic kidney disease | 41 (27.9%) | 37 (28.9%) | 4 (21.1%) | 0.59 |
| Diabetes | 34 (23.1%) | 33 (25.8%) | 1 (5.3%) | 0.08 |
| COPD | 30 (20.4%) | 24 (18.8%) | 6 (31.6%) | 0.20 |
| NYHA IV heart failure | 5 (3.4%) | 5 (3.9%) | 0 (0%) | 1.0 |
| Liver cirrhosis | 5 (3.4%) | 5 (3.9%) | 0 (0%) | 1.0 |
| Recent (<3 months) trauma | 6 (4.1%) | 6 (4.7%) | 0 (0%) | 1.0 |
| Recent (<3 months) burns | 0 (0%) | - | - | - |
| Vital parameters | ||||
| Blood pressure | ||||
| SBP (mmHg) | 112 ± 26 | 114 ± 27 | 99 ± 19 | 0.017 |
| DBP (mmHg) | 63 ± 15 | 65 ± 15 | 56 ± 11 | 0.005 |
| MAP (mmHg) | 80 ± 17 | 81 ± 18 | 70 ± 12 | 0.006 |
| Heart rate (bpm) | 99 ± 20 | 98 ± 19 | 106 ± 23 | 0.04 |
| Respiratory rate (bpm) | 20 ± 6 | 19 ± 6 | 24 ± 7 | 0.03 |
| SpO2 (%) | 93 ± 5 | 93 ± 5 | 92 ± 7 | 0.40 |
| Temperature (°C) | 38.0 ± 1.6 | 38.2 ± 1.2 | 36.5 ± 2.6 | 0.001 |
| AVPU scale | ||||
| Awake | 112 (76.2%) | 101 (78.9%) | 11 (57.9%) | 0.05 |
| Vocal | 10 (6.8%) | 9 (7.0%) | 1 (5.3%) | 0.8 |
| Pain | 5 (3.4%) | 3 (2.3%) | 2 (10.5%) | 0.13 |
| Unresponsive | 20 (13.6%) | 15 (11.7%) | 5 (26.3%) | 0.14 |
| Glasgow Coma Scale (GCS) | 13 ± 4 | 13 ± 4 | 11 ± 5 | 0.05 |
| Laboratory parameters | ||||
| P/F ratio | 286 ± 97 Missing: 16 (10.9%) |
293 ± 93 | 238 ± 111 | 0.06 |
| White blood cells (×109) | 14.69 ± 9.40 | 14.35 ± 9.00 | 16.92 ± 11.82 | 0.52 |
| Hemoglobin (g/dL) | 12.1 ± 2.4 | 12.4 ± 2.3 | 10.5 ± 2.3 | 0.002 |
| Hematocrit (%) | 37.2 ± 7.0 | 37.7 ± 6.7 | 33.6 ± 8.0 | 0.01 |
| Platelets (×103) | 214 ± 128 | 212 ± 125 | 228 ± 145 | 0.55 |
| Creatinine (mg/dL) | 2.0 ± 1.9 | 1.91 ± 1.6 | 2.70 ± 3.22 | 0.27 |
| Bilirubin (mg/dL) | 1.1 ± 0.9 | 1.1 ± 0.8 | 1.2 ± 1.0 | 0.98 |
| Final diagnosis | ||||
| Sepsis-3, sepsis | 109 (74.1%) | 98 (85.2%) | 11 (57.9%) | 0.10 |
| Sepsis-3, septic shock | 38 (25.9%) | 30 (23.4%) | 8 (42.1%) | 0.10 |
| Microbiology | ||||
| Positive cultures | 75 (51.0%) | 66 (52.4%) | 9 (47.4%) | 0.68 |
| Gram positive | 25 (17.0%) | 23 (18.0%) | 2 (11.1%) | 0.53 |
| Gram negative | 29 (19.7%) | 25 (19.5%) | 4 (22.2%) | 1.0 |
| Fungal | 3 (2.0%) | 3 (2.3%) | 0 (0%) | 1.0 |
| Multiple microorganisms | 17 (11.6%) | 15 (11.7%) | 2 (11.1%) | 1.0 |
| Origin of infection | ||||
| Lungs | 57 (38.8%) | 47 (36.7%) | 10 (52.6%) | 0.18 |
| Urinary tract | 35 (23.8%) | 33 (25.8%) | 2 (10.5%) | 0.25 |
| Soft tissue | 7 (4.8%) | 7 (5.5%) | 0 (0%) | 0.60 |
| Gastrointestinal | 21 (14.3%) | 18 (14.1%) | 3 (15.8%) | 0.74 |
| Joints | 5 (3.4%) | 4 (3.1%) | 1 (5.3%) | 0.50 |
| Heart valves | 1 (0.7%) | 1 (0.8%) | 0 (0%) | 1.0 |
| Central venous catheter associated/Bacteriemia | 9 (6.1%) | 8 (6.3%) | 1 (5.3%) | 1.0 |
| Unknown | 15 (10.2%) | 13 (10.2%) | 2 (10.5%) | 1.0 |
| Treatment | ||||
| Antibiotics | ||||
| Any | 147 (100%) | 128 (100%) | 19 (100%) | - |
| Ceftriaxone | 38 (25.9%) | 34 (26.6%) | 4 (21.1%) | 0.78 |
| Piperacillin/Tazobactam | 47 (32.0%) | 40 (31.3%) | 7 (36.8%) | 0.61 |
| Carbapenems | 46 (31.3%) | 40 (31.3%) | 6 (31.6%) | 1 |
| Vancomicin | 26 (17.7%) | 21 (16.4%) | 5 (26.3%) | 0.1 |
| Vasopressors | 38 (25.9%) | 30 (23.4%) | 8 (42.1%) | 0.10 |
| Corticosteroids | 32 (21.8%) | 27 (31.4%) | 5 (55.6%) | 0.56 |
| Conventional oxygen therapy | 28 (19.0%) | 18 (14.1%) | 10 (52.6%) | <0.001 |
| Non-invasive mechanical ventilation | 21 (14.3%) | 14 (10.9%) | 7 (36.8%) | 0.007 |
| Mechanical ventilation | 24 (16.3%) | 17 (13.3%) | 7 (36.8%) | 0.02 |
| Renal replacement therapy | 15 (10.2%) | 11 (8.6%) | 4 (21.1%) | 0.03 |
| Biomarkers at ED presentation | ||||
| MR-proADMt0 (nmol/L) | 1.93 (1.10–4.28) | 1.79 (1.07–3.78) | 3.19 (1.36–9.37) | 0.03 |
| PCT (ng/mL) | 2.2 (0.64–12.3) Missing: 8 (5.4%) |
2.0 (0.6–11.3) | 6.9 (0.8–15.3) | 0.31 |
| Lactate (mmol/L) | 2.0 (1.1–3.3) Missing: 32 (21.8%) |
1.9 (1.1–3.3) | 2.7 (1.7–6.3) | 0.05 |
| CRP (mg/L) | 55 (16–192) | 64 (17–197) | 30 (8–98) | 0.12 |
| Biomarkers at 72-h from presentation | ||||
| MR-proADMt72h (nmol/L) | 1.41 (0.84–2.89) Missing: 21 (14.3%) |
1.29 (0.82–2.30) | 4.31 (2.00–8.86) | <0.001 |
| PCT (ng/mL) | 2.3 (0.58–12.2) Missing: 56 (38.1%) |
1.9 (0.6–11.5) | 19.3 (8.1–26.3) | 0.14 |
| Lactate (mmol/L) | 1.4 (0.9–1.8) Missing: 123 (83.7%) |
1.0 (0.9–1.6) | 2.3 (1.6–5.7) | 0.04 |
| CRP (mg/L) | 114 (51–194) Missing: 55 (37.4%) |
111 (54–190) | 196 (33–279) | 0.44 |
| MR-proADM%change | −26% [−53–(−3%)] Missing: 21 (14.3%) |
−28% [−55–(−8%)] | 2% (−14–7%) | 0.002 |
| Severity scores at ED presentation | ||||
| SOFA score | 4 (2–6) | 4 (2–6) | 6 (4–7) | 0.03 |
| APACHE II | 21 (15–26) | 20 (15–24) | 29 (23–37) | <0.001 |
CAD = coronary artery disease, HIV = human immunodeficiency virus, COPD = chronic obstructive pulmonary disease, NYHA = New York Heart Association classification, SBP = systolic blood pressure, DBP = diastolic blood pressure, MAP = mean arterial pressure, SpO2 = peripheral oxygen saturation, P/F ratio = arterial partial oxygen pressure and fraction of inspired oxygen ratio, ED = emergency department, MR-proADM = mid-regional proadrenomedullin, PCT = procalcitonin, CRP = C-reactive protein.