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Table 3 Clinical characteristics, empiric treatment, and outcomes of patients stratified by risk for MRSA

From: Patients presenting to the hospital with MRSA pneumonia: differentiating characteristics and outcomes with empiric treatment

 

Stratification by Shorr risk scoring scheme

 

Low risk (0–1)

Medium risk (2–5)

High risk (6–10)

 

MRSA n = 9 (%)

Non-MRSA n = 74 (%)

P value

MRSA n = 86 (%)

Non-MRSA n = 58 (%)

P value

MRSA n = 39 (%)

Non-MRSA n = 2 (%)

P value

Variables used in Shorr’s risk scoring scheme

Age [median (IQRa)]

66 (61,76)

74.5 (61,84.3)

0.42

84 (72.8, 89.3)

77 (63.5,85.3)

0.01

82 (76,93)

85.5 (82,89)

0.7

Recent hospitalization within 90 d

0

0

 

27 (31)

26 (45)

0.12

35 (90)

1 (50)

0.23

Prior antibiotic exposure in last 30 d

0

2 (3)

1

20 (23)

8 (14)

0.2

22 (56)

1 (50)

1

SNF

5 (56)

3 (4)

0.0002

63 (73)

18 (31)

<0.0001

30 (77)

2 (100)

1

Admission into ICU

0

0

 

34 (40)

16 (28)

0.16

29 (74)

2 (100)

1

History of CVA

0

1 (1)

1

23 (27)

8 (14)

0.1

18 (46)

1 (50)

1

Female with diabetes

1 (11)

3 (4)

0.37

15 (17)

9 (16)

0.82

9 (23)

0

0.07

Additional variables identified in this study (not included in Shorr’s risk scoring scheme)

APACHE II [median (IQR)]

11 (8,18.5)

9 (7,11)

0.1

15 (11, 19.3)

12 (8,17)

0.006

18 (13,22)

21.5 (21,22)

0.52

PSI IV and V

8 (89)

31 (42)

0.01

78 (91)

38 (66)

0.0004

37 (95)

2 (100)

1

Vasopressor

0

0

 

25 (29)

6 (10)

0.0075

20 (51)

2 (100)

0.49

Mechanical ventilation

1 (11)

0

0.11

27 (31)

13 (22)

0.26

19 (49)

1 (50)

1

Prior antibiotic exposure in last 90 d

1 (11)

3 (4)

0.37

29 (34)

19 (33)

1

35 (90)

1 (50)

0.23

History of MRSA infection

1 (11)

1 (1)

0.2

19 (22)

0

<0.0001

7 (18)

0

1

History of pneumonia

1 (11)

5 (7)

0.5

33 (38)

10 (17)

0.009

22 (56)

1 (50)

1

Presence of other infections at admission

1 (11)

1 (1)

0.2

36 (42)

11 (19)

0.006

18 (46)

1 (50)

1

Presence of feeding tube

0

0

 

32 (37)

13 (22)

0.07

34 (87)

2 (100)

1

Treatment

Empiric anti-MRSA therapy

3 (33)

15 (20)

0.4

58 (67)

22 (38)

0.0006

27 (69)

1 (50)

0.54

Vancomycin

2 (67)

15 (100)

0.17

53 (62)

20 (91)

0.002

21 (54)

1 (100)

1

Other agents

1 (33)

0

 

5 (6)

2 (9)

0.7

6 (15)

0

1

Outcomes

Time to stability [median days (IQR)]

4 (3,11)

1 (1,4)

0.03

6 (4,10)

4 (1,7)

0.052

6.5 (5.3,12.8)

9.5 (0,19)

#

Clinical failure

1 (11)

0

0.11

23 (27)

5 (9)

0.0092

14 (36)

0

0.54

Mortality 28-day

0

0

 

18 (21)

4 (7)

0.03

11 (28)

0

1

LOSb survivors [median days (IQR)]

9.5 (7,15)

4.5 (3,7)

0.0005

10 (7,14)

7 (5,14.3)

0.1

10 (6,17)

12.5 (5,20)

0.93

Readmission 30-day

2 (22)

3 (4)

0.09

10 (12)

9 (16)

0.65

6 (15)

0

1

  1. NOTE: aIQR = interquartile range; bLOS = length of stay; CVA = cerebral vascular accident; SNF = skilled nursing facility; PSI = Pneumonia Severity Index; APACHE = Acute Physiology and Chronic Health Evaluation; # n too small.
  2. Chi-square test done for categorical variables; p value < 0.05 denotes significance.
  3. Wilcoxon-Mann–Whitney test done for all continuous variables; p value < 0.05 denotes significance.