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Table 1 Comparison of 21,383 episodes of abnormal temperature (fever vs. hypothermia) among 15,788 adult inpatients

From: Blood culture utilization practices among febrile and/or hypothermic inpatients

Variable

Total n = 21,383α; n (%)

Febrile episodes

n = 13,093; n (%)

Hypothermic episodes

n = 8290; n (%)

p-value

Age in years, median (IQR)

59 (46–69)

57 (42–67)

62 (51–71)

< 0.0001

Gender

   

0.218

  Male

11,841 (55.4)

7294 (55.7)

4547 (54.8)

 

  Female

9542 (44.6)

5799 (44.3)

3743 (45.2)

 

Race

   

0.350

  White

14,036 (65.6)

8626 (65.9)

5410 (65.3)

 

  Black and others

7347 (34.4)

4467 (34.1)

2880 (34.7)

 

Hospital-onset

12,563 (58.8)

7656 (58.5)

4907 (59.2)

0.299

Shift work during detection of abnormal body temperature

   

< 0.0001

  Day (8am to 8pm)

12,349 (57.8)

7279 (55.6)

5070 (61.2)

 

  Night (8pm to 8am of the following

day)

9034 (42.2)

5814 (44.4)

3220 (38.8)

 

Weekend (Saturday & Sunday)

5512 (25.8)

3599 (27.5)

1913 (23.1)

< 0.0001

Mechanical ventilation

8887 (41.6)

4900 (37.4)

3987 (48.1)

< 0.0001

Indwelling urinary catheter

13,991 (65.4)

8040 (61.4)

5951 (71.8)

< 0.0001

Central venous catheter

14,367 (67.2)

8856 (67.6)

5511 (66.5)

0.078

Comorbidities

    

  Congestive heart failure

5873 (27.5)

2801 (21.4)

3072 (37.1)

< 0.0001

  Chronic lung disease

5101 (23.9)

2824 (21.6)

2277 (27.5)

< 0.0001

  Diabetes mellitus

5866 (27.4)

3282 (25.1)

2584 (31.2)

< 0.0001

  Chronic liver failure

3465 (16.2)

1720 (13.1)

1745 (21.0)

< 0.0001

  End stage renal disease

5029 (23.5)

2393 (18.3)

2636 (31.8)

< 0.0001

  Malignancy

2852 (13.3)

1721 (13.1)

1131 (13.6)

0.296

  HIV infection

256 (1.2)

178 (1.4)

78 (0.9)

0.007

SIRS status

    

  No SIRS

6185 (28.9)

3975 (30.4)

2210 (26.7)

Reference

  SIRS alone

4467 (20.9)

3187 (24.3)

1280 (15.4)

< 0.0001

  SIRS plus hypotension

10,731 (50.2)

5931 (45.3)

4800 (57.9)

< 0.0001

WBC

    

  Normal or not done

7282 (34.1)

3862 (29.5)

3420 (41.3)

Reference

  <4,000 /mm3

3713 (17.3)

2801 (21.4)

912 (11.0)

< 0.0001

  >12,000 /mm3

10,388 (48.6)

6430 (49.1)

3958 (47.7)

< 0.0001

Associated blood culture obtained

(within one calendar day)

7850 (36.7)

6758 (51.6)

1092 (13.2)

< 0.0001

Positive blood cultures

    

  True positive

672 (3.1)

603 (4.6)

69 (0.8)

0.004

  Contaminationβ

44 (0.2)

38 (0.3)

6 (0.1)

1.00

Department during detection of abnormal body temperature

    

  Emergency department

648 (3.0)

256 (2.0)

392 (4.7)

< 0.0001

  General medicine 

2854 (13.3)

2042 (15.6)

812 (9.8)

Reference

  Surgery

2669 (12.4)

1853 (14.2)

816 (9.9)

0.084

  ICU

10,127 (47.4)

5361 (40.9)

4766 (57.5)

< 0.0001

  SCT / medical oncology

2565 (12.0)

2240 (17.1)

325 (3.9)

< 0.0001

  Cardiology

359 (1.7)

143 (1.1)

216 (2.6)

< 0.0001

  Neurology / neurosurgery

623 (2.9)

359 (2.7)

264 (3.2)

< 0.0001

  Gynecologic oncology

226 (1.1)

191 (1.5)

35 (0.4)

< 0.0001

  Obstetrics

421 (2.0)

280 (2.1)

141 (1.7)

0.034

  Orthopedics

341 (1.6)

219 (1.7)

122 (1.5)

0.005

  Psychiatry

421 (2.0)

80 (0.6)

341 (4.1)

< 0.0001

  Others

129 (0.6)

69 (0.5)

60 (0.7)

< 0.0001

Length of stay in days, median (IQR)

12 (6–26)

12 (6–27)

12 (5–26)

0.952

Discharge statusγ

    

  Home

12,176 (56.9)

7995 (61.1)

4181 (50.5)

Reference

  Facilityµ

6020 (28.2)

3663 (28.0)

2357 (28.4)

< 0.0001

  In-hospital death

3183 (14.9)

1431 (10.9)

1752 (21.1)

< 0.0001

  1. ICU, intensive care unit; IQR, interquartile range; HIV, human immunodeficiency virus; SCT, stem cell transplant; SIRS, systemic inflammatory response syndrome; WBC, white blood count
  2. αNumber of fever or hypothermia episodes per admission (median 1; IQR 1 to 2; minimum 1 and maximum 14)
  3. β46 organisms were isolated from 44 contaminant blood cultures
  4. γMissing 4 (hyperthermia-4; hypothermia-0)
  5. µIncludes skilled nursing facility (n = 3,106), other facility (n = 2,909), and remained in the hospital at the end of study period (n = 5)