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Table 3 Clinical outcomes, antimicrobial and supportive treatment of adult patients with community-acquired sepsis by severity group

From: Clinical and microbiological characteristics and outcomes of community-acquired sepsis among adults: a single center, 1-year retrospective observational cohort study from Hungary

Parametersa

Total (n = 214)

Sepsis (n = 83)

Severe sepsis (n = 70)

Septic shock (n = 61)

p value

In-hospital mortality

30 (14.0)

0

4 (5.7)

26 (42.6)

< 0.01**,***

Time to death from admission (days, median ± IQR, min–max)

8.0 ± 12.5 (1–40)

0

5.0 ± 8.8 (2–19)

7.0 ± 10.8 (1–40)

0.6

ICU admittance

58 (27.1)

7 (8.4)

16 (22.9)

35 (57.4)

< 0.01*,**,***

LOS (days, median ± IQR, min–max)

10.0 ± 8.0 (1–123)

10.0 ± 7.5 (3–80)

10.0 ± 6.0 (1–123)

7.0 ± 13.8 (1–80)

0.96

ICU LOS (days, median ± IQR, min–max)

8.0 ± 10.8 (1–60)

9.0 ± 14.5 (2–22)

9.0 ± 7.0 (1–50)

8.0 ± 11.0 (1–60)

0.95

Rate of source control

39 (18.2)

13 (15.7)

13 (18.6)

13 (21.3)

0.76

Rate of bacteraemia

109 (50.9)

37 (44.6)

40 (57.1)

32 (52.5)

0.29

No. of patients receiving antimicrobial therapy

212 (99.1)

82 (98.8)

70 (100)

60 (98.4)

0.44

Duration of antibiotic therapyb (days, median ± IQR, min–max)

10.0 ± 5.0 (1–50)

10.5 ± 4.0 (4–50)

10.0 ± 5.0 (2–28)

12.5 ± 13.0 (1–30)

0.61

Types of empirical antimicrobial therapy:

- Penicillins

26 (12.3)

15 (18.3)

3 (4.3)

8 (13.3)

0.02*

- Cephalosporins

153 (72.2)

56 (68.3)

55 (78.6)

42 (70.0)

0.7

- Carbapenems

16 (7.6)

1 (1.2)

5 (7.1)

10 (16.7)

0.01**

- Aminoglycosides

5 (2.4)

4 (4.8)

1 (1.4)

0

0.99

- Macrolides

1 (0.5)

0

0

1 (1.7)

1.0

- Fluoroquinolones

25 (11.8)

12 (14.6)

9 (12.9)

4 (6.7)

1.0

- Tetracyclines

2 (1.0)

0

1 (1.4)

1 (1.7)

0.97

- Metronidazol

11 (5.2)

3 (3.6)

3 (4.3)

5 (8.3)

0.99

- Clindamycin

7 (3.3)

1 (1.2)

1 (1.4)

5 (8.3)

0.88

- Vancomycin

20 (9.4)

6 (7.3)

5 (7.1)

9 (15.0)

0.99

- Fluconazole

1 (0.5)

1 (1.2)

0

0

1.0

Characteristics of antimicrobial therapy:

- No. of empirical combinations

45 (21.2)

14 (17.1)

11 (15.7)

20 (33.3)

0.06

- No. of adequate empirical antimicrobial therapy

190 (89.6)

74 (90.2)

63 (90.0)

53 (88.3)

0.84

- No. of escalations of antimicrobial therapy

36 (16.9)

9 (10.9)

14 (20.0)

13 (21.6)

0.17

- No. of de-escalations of antimicrobial therapy

30 (14.2)

12 (14.6)

4 (5.7)

14 (23.3)

0.02***

- No. of patients with subsequent oral switch

55 (25.9)

25 (30.5)

21 (30.0)

9 (15.0)

0.06

No. of patients receiving supportive therapy

87 (40.7)

15 (18.1)

28 (40.0)

44 (72.1)

< 0.01*,**,***

Types of supportive therapy:

- Hemodynamical support

47 (22.0)

0

2 (2.9)

45 (73.8)

< 0.01**,

- Mechanical ventilation

40 (18.7)

2 (2.4)

10 (14.3)

28 (45.9)

< 0.01*,**,***

- Renal replacement therapy

6 (2.8)

0

1 (1.4)

5 (8.2)

0.01**

- Any corticosteroid therapy

33 (15.4)

10 (12.0)

14 (20.0)

9 (14.8)

0.39

- Human albumin

17 (7.9)

2 (2.4)

3 (4.3)

12 (19.7)

< 0.01**,***

- Red blood cell transfusion

43 (20.1)

5 (6.0)

12 (17.1)

26 (42.6)

< 0.01**,***

- Thrombocyte transfusion

15 (7.0)

1 (1.2)

2 (2.9)

12 (19.7)

< 0.01**,***

Duration of supportive therapy (days, median ± IQR, min–max):

- Hemodynamical support

4.0 ± 7.0 (1–30)

0

2.0 ± 1.0 (1–3)

4.5 ± 8.3 (1–30)

0.11

- Mechanical ventilation

7.0 ± 8.0 (1–27)

12.5 ± 4.5 (8–17)

7.0 ± 5.5 (1–20)

7.0 ± 10.5 (1–27)

0.66

- Renal replacement therapy

7.5 ± 8.8 (1–15)

0

1 (1–1)

10.0 ± 9.0 (4–15)

0.33

- Any corticosteroid therapy

5.0 ± 6.0 (1–20)

6.0 ± 5.0 (3–14)

5.0 ± 3.0 (2–20)

6.0 ± 9.5 (1–18)

0.68

- Human albumin

4.0 ± 2.0 (1–10)

3.5 ± 1.5 (2–5)

5.0 ± 1.5 (3–6)

4.0 ± 2.0 (1–10)

0.73

  1. a All data are reported in absolute numbers and relative percentages (n, %), unless otherwise specified
  2. b Overall duration of empirical and targeted antimicrobial therapy
  3. * p < 0.05 for comparison between the groups sepsis and severe sepsis
  4. ** p < 0.05 for comparison between the groups sepsis and septic shock
  5. *** p < 0.05 for comparison between the groups severe sepsis and septic shock