TABLE 2.
Prognostic impacts of hourly AAT delays in the middle-aged, old, and very old groups.
| Variable | Patient number (%)* |
Univariable analysis |
Multivariable analysis |
|||
| Death | Survival | OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
| The middle-aged patient (n = 968) | n = 138 | n = 830 | ||||
| Delayed AAT, hour, median (IQR) | 2.0 (1.0–21.2) | 2.0 (0.9–6.0) | – | <0.001 | 1.002 (1.000–1.004) | 0.03 |
| Gender, male | 96 (69.6) | 438 (52.8) | 2.05 (1.39–3.01) | < 0.001 | NS | NS |
| Nursing-home residence | 10 (7.2) | 17 (2.0) | 3.74 (1.67–8.34) | 0.001 | NS | NS |
| Polymicrobial bacteremia | 23 (16.7) | 51 (6.1) | 3.06 (1.80–5.19) | < 0.001 | NS | NS |
| Pitt bacteremia score ≥4 | 85 (61.6) | 83 (10.0) | 14.43 (9.57–21.78) | <0.001 | 12.39 (7.75–19.81) | < 0.001 |
| Source of bacteremia | ||||||
| Pneumonia | 52 (37.7) | 63 (7.6) | 7.36 (4.79–11.31) | <0.001 | 4.11 (2.37–7.12) | < 0.001 |
| Urinary tract infection | 16 (11.6) | 275 (33.1) | 0.27 (0.15–0.46) | < 0.001 | 0.57 (0.30–1.08) | 0.09 |
| Liver abscess | 1 (0.7) | 42 (5.1) | 0.14 (0.02–1.00) | 0.02 | 0.14 (0.02–1.14) | 0.07 |
| Fatal comorbidity (McCabe and Jackson classification) | 80 (58.0) | 205 (24.7) | 4.21 (2.90–6.11) | <0.001 | 2.26 (1.33–3.83) | 0.002 |
| Comorbidity | ||||||
| Hemato-oncology | 80 (58.0) | 228 (27.5) | 3.64 (2.51–5.28) | < 0.001 | 1.73 (1.00–3.00) | 0.05 |
| Diabetes mellitus | 40 (29.0) | 325 (39.2) | 0.63 (0.43–0.94) | 0.02 | NS | NS |
| Liver cirrhosis | 36 (26.1) | 134 (16.1) | 1.83 (1.20–2.80) | 0.004 | NS | NS |
| The old patient (n = 683) | n = 104 | n = 579 | ||||
| Delayed AAT, hour, median (IQR) | 3.0 (2.0–39.3) | 2.0 (1.0–6.0) | – | <0.001 | 1.004 (1.002–1.006) | < 0.001 |
| Gender, male | 61 (58.7) | 248 (42.8) | 1.89 (1.24–2.89) | 0.003 | NS | NS |
| Pitt bacteremia score ≥4 | 65 (62.5) | 79 (13.6) | 10.55 (6.64–16.75) | <0.001 | 11.08 (6.40–19.19) | < 0.001 |
| Source of bacteremia | ||||||
| Pneumonia | 35 (33.7) | 53 (9.2) | 5.03 (3.07–8.26) | < 0.001 | 1.88 (1.00–3.53) | 0.05 |
| Urinary tract infection | 16 (15.4) | 224 (38.7) | 0.29 (0.17–0.50) | <0.001 | 0.50 (0.26–0.97) | 0.04 |
| Fatal comorbidity (McCabe and Jackson classification) | 56 (53.8) | 139 (24.0) | 3.69 (2.40–5.68) | <0.001 | 4.90 (2.88–8.33) | < 0.001 |
| Comorbid hemato-oncology | 55 (52.9) | 184 (31.8) | 2.41 (1.58–3.68) | < 0.001 | NS | NS |
| The very old patient (n = 1265) | n = 207 | n = 1058 | ||||
| Delayed AAT, hour, median (IQR) | 3.0 (1.2–40.0) | 2.0 (1.1–8.0) | – | <0.001 | 1.007 (1.004–1.011) | < 0.001 |
| Nursing-home Residence | 35 (16.9) | 80 (7.6) | 2.49 (1.62–3.82) | <0.001 | 1.81 (1.04–3.15) | 0.03 |
| Polymicrobial bacteremia | 41 (19.8) | 110 (10.4) | 2.13 (1.43–3.16) | <0.001 | 1.71 (1.03–2.82) | 0.04 |
| Pitt bacteremia score ≥4 | 140 (67.6) | 157 (14.8) | 1.88 (1.37–2.56) | <0.001 | 9.27 (6.32–15.60) | < 0.001 |
| Inadequate source control during antibiotic therapy | 18 (8.7) | 21 (2.0) | 4.70 (2.50–8.99) | <0.001 | 4.70 (2.10–10.54) | < 0.001 |
| Source of bacteremia | ||||||
| Pneumonia | 86 (41.5) | 158 (14.9) | 0.05 (2.93–5.60) | < 0.001 | ||
| Urinary tract infection | 18 (8.7) | 413 (39.0) | 0.15 (0.09–0.25) | <0.001 | 0.19 (0.11–0.33) | < 0.001 |
| Biliary tract infection | 8 (3.9) | 132 (12.5) | 0.28 (0.14–0.59) | <0.001 | 0.21 (0.09–0.50) | < 0.001 |
| Fatal comorbidity (McCabe and Jackson classification) | 78 (29.5) | 129 (12.9) | 2.84 (2.05–3.91) | <0.001 | 2.66 (1.77–4.01) | < 0.001 |
| Comorbidity | ||||||
| Hypertension | 121 (58.5) | 695 (65.7) | 0.74 (0.54–1.00) | 0.047 | NS | NS |
| Hemato-oncology | 81 (39.1) | 270 (25.5) | 1.88 (1.37–2.56) | <0.001 | NS | NS |
| Liver cirrhosis | 31 (15.0) | 69 (6.5) | 2.53 (1.61–3.97) | <0.001 | 2.60 (1.46–4.64) | 0.001 |
| Urological disease | 16 (7.7) | 137 (12.9) | 0.56 (0.33–0.97) | 0.04 | NS | NS |
AAT, appropriate antimicrobial therapy; CI, confidence interval; IQR, interquartile range; OR, odds ratio; NS, not significant (by backward multivariable regression). Boldface indicates statistical significance (P < 0.05) in the logistic regression model. *Data are expressed as numbers (%), unless indicated specifically.