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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

ParametersaTotal (n = 214)Sepsis (n = 83)Severe sepsis (n = 70)Septic shock (n = 61)p value
In-hospital mortality30 (14.0)04 (5.7)26 (42.6)< 0.01**,***
Time to death from admission (days, median ± IQR, min–max)8.0 ± 12.5 (1–40)05.0 ± 8.8 (2–19)7.0 ± 10.8 (1–40)0.6
ICU admittance58 (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 control39 (18.2)13 (15.7)13 (18.6)13 (21.3)0.76
Rate of bacteraemia109 (50.9)37 (44.6)40 (57.1)32 (52.5)0.29
No. of patients receiving antimicrobial therapy212 (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:
- Penicillins26 (12.3)15 (18.3)3 (4.3)8 (13.3)0.02*
- Cephalosporins153 (72.2)56 (68.3)55 (78.6)42 (70.0)0.7
- Carbapenems16 (7.6)1 (1.2)5 (7.1)10 (16.7)0.01**
- Aminoglycosides5 (2.4)4 (4.8)1 (1.4)00.99
- Macrolides1 (0.5)001 (1.7)1.0
- Fluoroquinolones25 (11.8)12 (14.6)9 (12.9)4 (6.7)1.0
- Tetracyclines2 (1.0)01 (1.4)1 (1.7)0.97
- Metronidazol11 (5.2)3 (3.6)3 (4.3)5 (8.3)0.99
- Clindamycin7 (3.3)1 (1.2)1 (1.4)5 (8.3)0.88
- Vancomycin20 (9.4)6 (7.3)5 (7.1)9 (15.0)0.99
- Fluconazole1 (0.5)1 (1.2)001.0
Characteristics of antimicrobial therapy:
- No. of empirical combinations45 (21.2)14 (17.1)11 (15.7)20 (33.3)0.06
- No. of adequate empirical antimicrobial therapy190 (89.6)74 (90.2)63 (90.0)53 (88.3)0.84
- No. of escalations of antimicrobial therapy36 (16.9)9 (10.9)14 (20.0)13 (21.6)0.17
- No. of de-escalations of antimicrobial therapy30 (14.2)12 (14.6)4 (5.7)14 (23.3)0.02***
- No. of patients with subsequent oral switch55 (25.9)25 (30.5)21 (30.0)9 (15.0)0.06
No. of patients receiving supportive therapy87 (40.7)15 (18.1)28 (40.0)44 (72.1)< 0.01*,**,***
Types of supportive therapy:
- Hemodynamical support47 (22.0)02 (2.9)45 (73.8)< 0.01**,
- Mechanical ventilation40 (18.7)2 (2.4)10 (14.3)28 (45.9)< 0.01*,**,***
- Renal replacement therapy6 (2.8)01 (1.4)5 (8.2)0.01**
- Any corticosteroid therapy33 (15.4)10 (12.0)14 (20.0)9 (14.8)0.39
- Human albumin17 (7.9)2 (2.4)3 (4.3)12 (19.7)< 0.01**,***
- Red blood cell transfusion43 (20.1)5 (6.0)12 (17.1)26 (42.6)< 0.01**,***
- Thrombocyte transfusion15 (7.0)1 (1.2)2 (2.9)12 (19.7)< 0.01**,***
Duration of supportive therapy (days, median ± IQR, min–max):
- Hemodynamical support4.0 ± 7.0 (1–30)02.0 ± 1.0 (1–3)4.5 ± 8.3 (1–30)0.11
- Mechanical ventilation7.0 ± 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 therapy7.5 ± 8.8 (1–15)01 (1–1)10.0 ± 9.0 (4–15)0.33
- Any corticosteroid therapy5.0 ± 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 albumin4.0 ± 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