Skip to main content

Table 4 Characteristics of the cohort based on the receipt of inappropriate empiric treatment

From: Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis

 

Non-IET

%

IET

%

P-value

N = 32,710

N = 4984

Baseline characteristics

 Mean age, years (SD)

69.0 (16.0)

 

69.4 (15.3)

 

0.094

 Gender: male

13,680

41.8%

2169

43.5%

0.024

 Race

  White

23,921

73.1%

3443

69.1%

<0.001

  Black

4384

13.4%

862

17.3%

  Hispanic

919

2.8%

163

3.3%

  Other

3486

10.7%

516

10.4%

 Admission Source

  Non-healthcare facility (including from home)

21,450

65.6%

3034

60.9%

<0.001

  Clinic

1093

3.3%

138

2.8%

  Transfer from ECF

2996

9.2%

759

15.2%

  Transfer from another non-acute care facility

379

1.2%

77

1.5%

  Emergency Department

6688

20.4%

959

19.2%

  Other

104

0.3%

17

0.3%

 Elixhauser Comorbidities

  Congestive heart failure

7836

24.0%

1509

30.3%

<0.001

  Valvular disease

2594

7.9%

425

8.5%

0.148

  Pulmonary circulation disease

1912

5.8%

358

7.2%

<0.001

  Peripheral vascular disease

3564

10.9%

577

11.6%

0.152

  Paralysis

3289

10.1%

770

15.4%

<0.001

  Other neurological disorders

7227

22.1%

1269

25.5%

<0.001

  Chronic pulmonary disease

9079

27.8%

1663

33.4%

<0.001

  Diabetes without chronic complications

9695

29.6%

1623

32.6%

<0.001

  Diabetes with chronic complications

3152

9.6%

524

10.5%

0.052

  Hypothyroidism

5645

17.3%

942

18.9%

0.004

  Renal failure

9024

27.6%

1540

30.9%

<0.001

  Liver disease

1774

5.4%

245

4.9%

0.138

  Peptic ulcer disease with bleeding

15

0.0%

2

0.0%

1.000

  AIDS

8

0.0%

4

0.1%

0.063

  Lymphoma

508

1.6%

74

1.5%

0.716

  Metastatic cancer

1543

4.7%

182

3.7%

0.001

  Solid tumor without metastasis

1335

4.1%

163

3.3%

0.006

  Rheumatoid arthritis/collagen vascular

1422

4.3%

215

4.3%

0.914

  Coagulopathy

4626

14.1%

540

10.8%

<0.001

  Obesity

5079

15.5%

822

16.5%

0.081

  Weight loss

5583

17.1%

1117

22.4%

<0.001

  Fluid and electrolyte disorders

17,961

54.9%

2702

54.2%

0.357

  Chronic blood loss anemia

459

1.4%

79

1.6%

0.313

  Deficiency Anemia

12,735

38.9%

2096

42.1%

<0.001

  Alcohol abuse

1139

3.5%

163

3.3%

0.446

  Drug abuse

789

2.4%

103

2.1%

0.135

  Psychosis

1979

6.1%

294

5.9%

0.676

  Depression

4859

14.9%

806

16.2%

0.018

  Hypertension

20,987

64.2%

3154

63.3%

0.229

 Charlson Comoribidity Score

  0

10,353

31.7%

1239

24.9%

<0.001

  1

6517

19.9%

1072

21.5%

  2

6595

20.2%

1047

21.0%

  3

4223

12.9%

757

15.2%

  4

2400

7.3%

465

9.3%

  5+

2622

8.0%

404

8.1%

  Mean (SD)

1.9 (2.1)

 

2.0 (2.0)

 

<0.001

  Median [IQR]

1 [0, 3]

 

2 [1 3]

 

<0.001

Infection characteristics and treatment

 Infection characteristics

  Sepsis

10,736

32.8%

1468

29.5%

<0.001

  Pneumonia

3936

12.0%

995

20.0%

  UTI

18,038

55.1%

2521

50.6%

  HCA

11,413

34.9%

2221

44.6%

<0.001

  CRE

513

1.6%

648

13.0%

<0.001

 Illness severity

  ICU admission

13,524

41.3%

2074

41.6%

0.720

  Mechanical ventilation

5064

15.5%

1062

21.3%

<0.001

  Vasopressors

4929

15.1%

709

14.2%

0.111

 Antibiotics administered

  Aminoglycosides

3694

11.3%

351

7.0%

<0.001

  Antipseudomonal penicillins

6199

19.0%

347

7.0%

<0.001

  Antipseudomonal floroquinolones

15,995

48.9%

2480

49.8%

0.258

  Antipseudomonal penicillins with beta-lactamase inhibitors

16,874

51.6%

2008

40.3%

<0.001

  Extended spectrum cephalosporins

12,174

37.2%

1134

22.8%

<0.001

  Folate pathway inhibitors

225

0.7%

36

0.7%

0.809

  Penicillins with beta-lacatamase inhibitors

681

2.1%

147

2.9%

0.005

  Polymyxins

102

0.3%

32

0.6%

<0.001

  Tetracyclines

210

0.6%

15

0.3%

0.004

  Tigecycline

485

1.5%

110

2.2%

<0.001

  Aztreonam

1319

4.0%

258

5.2%

<0.001

Hospital Characteristics

 Area

  Midwest

8848

27.0%

1133

22.7%

<0.001

  Northeast

4397

13.4%

950

19.1%

  South

13,579

41.5%

1951

39.1%

  West

5886

18.0%

950

19.1%

 Number of Beds

   < 200

5597

17.1%

744

14.9%

<0.001

  200 to 299

7508

23.0%

1171

23.5%

  300 to 499

10,540

32.2%

1781

35.7%

  500+

9065

27.7%

1288

25.8%

  Teaching

12,096

37.0%

1988

39.9%

0.217

  Urban

29,418

89.9%

4574

91.8%

<0.001

  Hospital outcomes

  Mortality

3234

9.9%

607

12.2%

<0.001

  Mean (SD) LOS, days

9.0 (8.5)

 

14.7 (19.4)

 

<0.001

  Median [IQR] LOS, days

7 [4, 11]

 

9 [5, 16]

 

<0.001

  Mean (SD) costs, $

20,227 (25,616)

 

33,216 (49,567)

 

<0.001

  Median [IQR] costs, $

12,719 [7401, 23,275]

 

17,386 [9255, 35,625]

 

<0.001

Hospital outcomes stratified by infection type

 UTI

  Mortality

1548

8.6%

267

10.6%

<0.001

  Mean (SD) LOS, days

8.5 (7.8)

 

13.3 (17.1)

 

<0.001

  Median [IQR] LOS, days

6 [4, 10]

 

9 [5, 15]

 

<0.001

  Mean (SD) costs, $

18,103 (21,440)

 

28,069 (40,490)

 

<0.001

  Median [IQR] costs, $

11,862 [7015, 21,222]

 

16,209 [8828, 31,535]

 

<0.001

 Sepsis

  Mortality

1356

12.6%

260

17.7%

<0.001

  Mean (SD) LOS, days

9.9 (9.9)

 

18.9 (23.3)

 

<0.001

  Median [IQR] LOS, days

7 [4, 12]

 

12 [6, 22]

 

<0.001

  Mean (SD) costs, $

24,532 (32,043)

 

47,881 (64,812)

 

<0.001

  Median [IQR] costs, $

15,048 [8312, 28,558]

 

25,121 [12,382, 55,529]

 

<0.001

 Pneumonia

  Mortality

330

8.4%

80

8.0%

0.726

  Mean (SD) LOS, days

8.5 (7.6)

 

12.0 (17.6)

 

<0.001

  Median [IQR] LOS, days

7 [4, 10]

 

7 [4, 13]

 

<0.001

  Mean (SD) costs, $

18,220 (21,710)

 

24,623 (38,753)

 

<0.001

  Median [IQR] costs, $

11,742 [7125, 20,561]

 

13,040 [7393, 26,339]

 

<0.001

  1. IET inappropriate empiric therapy, SD standard deviation, ECF extended care facility, AIDS acquired immune deficiency syndrome, IQR interquartile range, HCA healthcare-associated, CSE carbapenem sensitive Enterobacteriaceae, CRE carbapenem resistant Enterobacteriaceae, UTI urinary tract infection, ICU intensive care unit, IQR interquartile range 25–75%
Back to article page

BMC Infectious Diseases

ISSN: 1471-2334

Contact us