Table 2.
Risk factors predicting 30-day mortality
| Characteristics | Univariate analysis | Multivariable analysis | ||
|---|---|---|---|---|
| Hazards ratio (95% CI) | P value | Adjusted Hazards ratio (95% CI) | P value | |
| Age | 1.01 (0.99,1.02) | 0.573 | 1 (0.98,1.02) | 0.772 |
| Male gender | 1.19 (0.74,1.92) | 0.463 | 1.4 (0.83,2.34) | 0.207 |
| Polymyxin E (colistin) resistance | 0.96 (0.53,1.74) | 0.904 | ||
| Hematologic condition | ||||
| Acute myeloid leukemia | 0.56 (0.30,1.04) | 0.065 | ||
| Acute lymphoblastic | 0.73 (0.38,1.40) | 0.34 | ||
| Leukemia | 0.74 (0.39,1.40) | 0.353 | ||
| Other malignant conditions Benign | Reference | – | ||
| No recovery from neutropenia | 5.42 (3.28,8.93) | < 0.001 | 4.28 (2.53,7.23) | < 0.001 |
| Prolonged and profound neutropenia a | 0.65 (0.37,1.13) | 0.13 | ||
| Transplant | 0.67 (0.41,1.11) | 0.121 | ||
| Intensive care requirement | 7.84 (3.39,18.12) | < 0.001 | 3.12 (1.23,7.93) | 0.017 |
| Presence of septic shock | 12.34 (4.5,33.88) | < 0.001 | 4.42 (1.47,13.28) | 0.008 |
| Dialysis requirement | 2.75 (1.57,4.81) | < 0.001 | 1.68 (0.92,3.05) | 0.091 |
| Primary organism Klebsiella pneumoniae | 0.87 (0.50,1.52) | 0.625 | ||
| Previous bacterial infections | 1.06 (0.64,1.75) | 0.818 | ||
| Concomitant bacterial infections | 1.6 (0.96,2.66) | 0.069 | ||
| Cytomegalovirus reactivationb | 2.31 (0.78,6.85) | 0.132 | ||
| Source of bacteremia: Probable gut translocationc | 0.89 (0.54,1.45) | 0.639 | ||
| Previous exposure to polymyxin | 1.22 (0.75,1.96) | 0.421 | ||
| Previous exposure to carbapenem | 0.99 (0.43,2.28) | 0.983 | ||
| Persistent bacteremia | 2.15 (1.35,3.41) | 0.001 | 1.74 (1.05,2.89) | 0.031 |
| Treatment details | ||||
| Ceftazidime-avibactam-based therapy | 0.82 (0.41,1.63) | 0.569 | ||
| Polymyxin with Ceftazidime-avibactam combination | 0.61 (0.36,1.04) | 0.067 | ||
| Avibactam combination | ||||
| Alternate agents | 0.75 (0.23,2.41) | 0.624 | ||
| Polymyxin based therapy | Reference | – | ||
| No appropriate empirical therapy receivedd | 0.50 (0.28,0.89) | 0.019 | 0.77 (0.42,1.41) | 0.389 |
Bold values represents significant risk factors after multivariable analysis
aProlonged and profound Neutropenia is defined as absolute neutrophil count < 100 cells/mm3 and a duration of 7 days
bCytomegalovirus reactivation- More than 1000 copies of cytomegalovirus present 7 days before or after bacterial isolation
cOther sources include pulmonary sources (6), central line related (19), Skin and soft tissue infections (14) and other or unknown sources (7)
dInappropriate empiric therapy was defined as receipt of agents without documented in vitro activity