Table 1 –
Patient characteristics
| Derivation Cohort | |||||
|---|---|---|---|---|---|
|
| |||||
| Characteristic | Total (N=1323)b |
Patients with neurotoxicity (N=34) |
Patients without neurotoxicity (N=1289) |
Odds ratio (95% CI) | P-value |
|
| |||||
| Male | 709 (54%) | 19 (56%) | 690 (54%) | 1.10 (0.55–2.18) | 0.79 |
|
| |||||
| Non-Hispanic Caucasian | 1229 (93%) | 34 (100%) | 1195 (93%) | 5.45 (0.33–90.98 | 0.24 |
|
| |||||
| Age (SD), years | 65 (16) | 72 (12) | 64 (16) | 1.43 (1.10–1.86) | 0.008 |
|
| |||||
| Weight, kg | 80 (67, 98) | 90 (73, 109) | 80 (66, 98) | 1.14 (1.05–1.24) | 0.003 |
|
| |||||
| BMI, kg/m2 | 27 (23, 33) | 30 (27, 36) | 27 (23, 32) | 1.04 (1.01–1.07) | 0.003 |
| < 18.5 | 91 (7%) | 1 (1%) | 90 (99%) | ||
| ≥18.5–25 | 402 (30%) | 6 (2%) | 400 (99%) | ||
| ≥25–30 | 376 (28%) | 9 (2%) | 367 (98%) | ||
| 30 | 454 (34%) | 18 (4%) | 436 (96) | ||
|
| |||||
| ICU type | |||||
| MICU | 462 (35%) | 10 (29%) | 452 (35%) | Reference | |
| Mixed | 283 (21%) | 6 (18%) | 277 (22%) | 0.98 (0.35–2.72) | 0.97 |
| medical/surgical SICU | 578 (44%) | 18 (53%) | 560 (43%) | 1.45 (0.66–3.18) | 0.35 |
|
| |||||
| APACHE III | 73 (59, 91) | 80 (68, 106) | 73 (59, 90) | 1.12 (0.99–1.27)a | 0.084 |
|
| |||||
| SOFA | 6 (4, 9) | 7 (5, 9) | 6 (4, 9) | 1.04 (0.95–1.13) | 0.42 |
|
| |||||
| Charlson Comorbidity Score at ICU admission | 6 (4, 9) | 8 (6, 10) | 6 (4, 9) | 1.10 (1.01–1.19) | 0.036 |
|
| |||||
| Creatinine clearance at ICU admission, mL/min | 75 (47, 115) | 61 (35, 103) | 76 (48, 115) | 0.98 (0.91–1.05)a | 0.49 |
| < 60 mL/minc | 522 (40%) | 18 (53%) | 504 (39%) | ||
|
| |||||
| ESRD on dialysis prior to admission | 33 (3%) | 1 (3%) | 32 (3%) | 1.75 (0.89–3.47) | 0.11 |
|
| |||||
| On dialysis within 12 hours of beta-lactam start | 78 (6%) | 2 (6%) | 76 (6%) | 1.00 (0.24–4.24) | 0.99 |
|
| |||||
| Beta-lactam selection, | 425 (32%) | 14 (41%) | 411 (32%) | Reference | |
| Cefepime | 387 (29%) | 8 (24%) | 379 (29%) | 0.62 (0.26–1.49) | 0.29 |
| Meropenem | 511 (39%) | 12 (35%) | 499 (39%) | 0.71 (0.32–1.54) | 0.38 |
| Piperacillin/tazobactam | |||||
|
| |||||
| Beta-lactam treatment duration, hours | 140 (84, 210) | 145 (88, 193) | 138 (84, 210) | 0.99 (0.96–1.02)a | 0.52 |
|
| |||||
| Beta-lactam dose appropriatenessd, | |||||
| Appropriate | 1194 (90%) | 31 (91%) | 1163 (90%) | Reference | |
| Dose too high | 17 (1%) | 0 (0%) | 17 (1%) | 1.06 (0.06–19.46) | 0.97 |
| Dose too low | 112 (9%) | 3 (9%) | 109 (9%) | 1.18 (0.38–3.64) | 0.77 |
Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; BMI, body mass index; CrCl, Cockcroft-Gault creatinine clearance; MICU, medical intensive care unit; SICU, surgical intensive care unit, SOFA, Sequential Organ Failure Assessment
a:
Per 10 unit increase
b:
Values expressed as counts (percentages) or medians (interquartile ranges) unless noted
c:
Creatinine clearance only calculated for patients not on dialysis (total 1246 patients)
d:
Assessed based on appropriate ranges outlined in table S3.