Table 5.
Analysis of Risk Factors of All-Cause Mortality After PMB Treatment
| Parameters | Survival | Death | P | Binary Logistic Regression | |||
|---|---|---|---|---|---|---|---|
| B | OR | 95% CI | P | ||||
| (N = 177) | (N = 91) | ||||||
| Sex (male) | 132 (74.6%) | 60 (65.9%) | 0.137 | ||||
| Age (years) | 55 (42–65) | 65 (49–76) | 0.001 | 0.009 | 1.009 | 0.990–1.028 | 0.343 |
| Mechanical ventilation | 102 (57.6%) | 87 (95.6%) | 0.000 | 1.901 | 6.691 | 1.838–24.354 | 0.004 |
| Vasoactive agents | 70 (39.5%) | 74 (81.3%) | 0.000 | 1.174 | 3.235 | 1.519–6.891 | 0.002 |
| Admission to ICU | 109 (61.6%) | 73 (80.2%) | 0.002 | 0.293 | 1.341 | 0.535–3.360 | 0.531 |
| APACHE II score | 19 (13.0–25.5) | 20 (14.0–27.5) | 0.232 | ||||
| Primary diseases | |||||||
| Cardiovascular and cerebrovascular diseases | 109 (61.6%) | 60 (65.9%) | 0.485 | ||||
| Respiratory diseases | 144 (81.4%) | 82 (90.1%) | 0.062 | 1.014 | 2.757 | 0.952–7.981 | 0.062 |
| Kidney disease | 80 (45.2%) | 40 (44.0%) | 0.847 | ||||
| Liver disease | 35 (19.8%) | 32 (35.2%) | 0.006 | 0.946 | 2.575 | 1.190–5.571 | 0.016 |
| Diseases of digestive system | 35 (19.8%) | 17 (18.7%) | 0.830 | ||||
| Nutritional diseases | 25 (14.1%) | 9 (9.9%) | 0.324 | ||||
| DM | 24 (13.6%) | 20 (22.0%) | 0.078 | 0.196 | 1.216 | 0.509–2.908 | 0.660 |
| Infection site | |||||||
| Respiratory tract | 167 (94.4%) | 87 (95.6%) | 0.662 | ||||
| Blood | 46 (26.0%) | 38 (41.8%) | 0.008 | 0.042 | 1.043 | 0.458–2.374 | 0.921 |
| Urinary system | 21 (11.9%) | 8 (8.8%) | 0.443 | ||||
| Intracranial | 16 (9.0%) | 1 (5.9%) | 0.024 | −1.344 | 0.261 | 0.024–2.807 | 0.268 |
| Digestive tract | 17 (9.6%) | 13 (14.3%) | 0.250 | ||||
| Wound | 16 (9.0%) | 5 (5.5%) | 0.306 | ||||
| Pathogenic bacteria | |||||||
| Acinetobacter baumannii | 114 (64.4%) | 64 (70.3%) | 0.331 | ||||
| Klebsiella pneumoniae | 67 (37.9%) | 25 (27.5%) | 0.090 | −0.182 | 0.834 | 0.411–1.692 | 0.614 |
| Pseudomonas aeruginosa | 51 (28.8%) | 18 (19.8%) | 0.109 | ||||
| E. coli or E. cloacae | 3 (1.7%) | 7 (7.7%) | 0.014 | 2.388 | 10.889 | 1.446–82.015 | 0.020 |
| Multiple site infection | 68 (38.4%) | 51 (56.0%) | 0.006 | 0.412 | 1.509 | 0.700–3.253 | 0.294 |
| Number of patients with CR-GNB>1 | 44 (24.9%) | 21 (23.1%) | 0.747 | ||||
| Antimicrobial susceptibility | |||||||
| Tigecycline MIC >2 (mg/L) | 107 (84.9%) | 57 (80.3%) | 0.403 | ||||
| Polymyxin MIC >2 (mg/L) | 6 (3.4%) | 2 (2.7%) | 0.602 | ||||
| Previous carbapenem treatment time (days) | 5 (0–12) | 5 (0–11) | 0.664 | ||||
| Previous tigecycline treatment time (days) | 0 (0–7.5) | 0 (0–7.0) | 0.433 | ||||
| Previous use of carbapenem | 117 (66.1%) | 60 (65.9%) | 0.978 | ||||
| Previous use of tigecycline | 75 (42.4%) | 34 (37.4%) | 0.429 | ||||
| Preemptive therapy | 140 (79.1%) | 67 (73.6%) | 0.312 | ||||
| Delay days of PMB use (days) | 0 (0–2) | 1 (0–3) | 0.608 | ||||
| Loading dose≥2.0mg/kg | 35 (19.8%) | 24 (26.4%) | 0.217 | ||||
| Maintenance dose≥1.25mg/kg q12h | 27 (15.3%) | 12 (13.2%) | 0.649 | ||||
| Use loading dose | 69 (39.0%) | 41 (45.1%) | 0.339 | ||||
| Loading dose (mg) | 50 (50–100) | 50 (50–100) | 0.113 | ||||
| Maintenance dose q12h (mg) | 50 (50–50) | 50 (50–50) | 0.006 | 0.027 | 1.027 | 0.970–1.088 | 0.353 |
| Maintenance dose (mg/kg q12h) | 0.83 (0.80–1) | 0.89 (0.83–1.0) | 0.279 | ||||
| Loading dose (mg/kg) | 1 (0.83–1.67) | 1 (0.83–1.72) | 0.312 | ||||
| Treatment duration time (days) | 11 (7–15) | 8.5 (4–12) | 0.000 | 0.132 | 1.141 | 0.874–1.489 | 0.331 |
| Cumulative dose (mg) | 1015 (600–1500) | 800 (400–1150) | 0.002 | −0.002 | 0.998 | 0.995–1.001 | 0.139 |
| Combination of drugs | |||||||
| Tigecycline | 48 (27.1%) | 38 (39.6%) | 0.038 | 0.463 | 1.590 | 0.804–3.143 | 0.183 |
| Carbapenems | 60 (33.9%) | 15 (16.5%) | 0.003 | −0.425 | 0.654 | 0.298–1.436 | 0.289 |
| β-lactams | 63 (35.6%) | 27 (29.7%) | 0.331 | ||||
| Glycopeptides | 29 (16.4%) | 15 (16.5%) | 0.983 | ||||
| Others | 28 (15.8%) | 13 (14.3%) | 0.741 | ||||
Notes: The patients in the death group were those who died in hospital or gave up treatment after aggravation of the disease. The parameters included in Binary logistic regression were those with P < 0.1 in univariate test. Bold font indicates data with significant differences. B indicates regression coefficient.
Abbreviations: PMB, Polymyxin B; ICU, Intensive Care Unit; APACHE II, Acute Physiology and Chronic Health Evaluation II; CR-GNB, Carbapenem-resistant Gram-negative Bacteria; MIC, minimum inhibitory concentration.