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 |