Clinical Study
Impact of Inappropriate Empiric Antimicrobial Therapy on Mortality of Septic Patients with Bacteremia: A Retrospective Study
Table 5
Univariate analysis of factors associated with 28-day and overall mortality.
| Factors | Total n (%) | 28-day mortality n (%) | value | OR (95% CI) | Overall mortality n (%) | value | OR (95% CI) |
| Age > 65 yrs | 111 (48.5) | 74 (66.7) | 0.221 | 1.42 (0.83–2.43) | 86 (77.5) | 0.030 | 1.97 (1.10–3.53) | Nosocomial infection | 81 (35.4) | 55 (67.9) | 0.108 | 1.44 (0.82–2.55) | 65 (80.2) | 0.016 | 2.20 (1.16–4.18) | Septic shock | 140 (61.1) | 96 (68.6) | 0.017 | 1.95 (1.13–3.38 | 102 (72.9) | 0.200 | 1.36 (0.77–2.43) | Inappropriate first dose | 68 (42.79) | 46 (67.6) | 0.292 | 1.38 (0.76–2.51) | 51 (75.0) | 0.213 | 1.39 (0.73–2.64) | Inappropriate 24-hour dose | 58 (25.33) | 38 (65.5) | 0.176 | 1.19 (0.64–2.23) | 43 (74.1) | 0.160 | 1.29 (0.66–2.52) | Duration from sepsis until first-dose antimicrobial therapy > 3 hours | 117 (51.1) | 79 (67.5) | 0.106 | 1.56 (0.91–2.67) | 90 (76.9) | 0.026 | 1.93 (1.08–3.43) | Wbc ≤ 4,000 per uL | 40 (17.5) | 33 (82.5) | 0.004 | 3.39 (1.43–8.04) | 34 (85.0) | 0.035 | 2.77 (1.10–6.94) | Plt ≤ 100,000 per uL | 109 (47.6) | 82 (75.2) | <0.001 | 2.94 (1.67–5.16) | 88 (80.7) | 0.001 | 2.698 (1.48–4.92) | HCO3− ≤ 20 mEq/L | 135 (59.0) | 92 (68.1) | 0.038 | 1.80 (1.05–3.11) | 96 (71.1) | 0.770 | 1.10 (0.62–1.95) | Albumin ≤ 3.2 g/dL | 171 (74.7) | 117 (68.4) | 0.002 | 2.67 (1.45–4.91) | 128 (74.9) | 0.013 | 2.26 (1.21–4.21) | APACHE II score ≥ 25 | 100 (43.7) | 79 (79.0) | <0.001 | 3.82 (2.11–6.90) | 81 (81.0) | 0.002 | 2.61 (1.41–4.82) | Serum cortisol ≥ 35 mg/dL () | 38 (59.4) | 29 (76.3) | 0.009 | 4.39 (1.49–12.93) | 30 (78.9) | 0.029 | 3.75 (1.25–11.21) | Serum lactate ≥ 2.2 mmol/L () | 26 (83.9) | 20 (76.9) | 0.027 | 13.33 (1.24–143.15) | 20 (76.9) | 0.027 | 13.33 (1.24–143.15) | Comorbidity > 4 | 84 (36.7) | 61 (42.7) | 0.017 | 2.04 (1.14–3.64) | 69 (42.9) | 0.003 | 2.65 (1.38–5.09) | Liver failure | 50 (21.8) | 38 (26.6) | 0.031 | 2.23 (1.09–4.56) | 42 (26.1) | 0.022 | 2.65 (1.17–5.99) | Congestive heart failure | 50 (21.8) | 38 (26.6) | 0.031 | 2.23 (1.09–4.56) | 41 (25.5) | 0.053 | 2.24 (1.02–4.92) | High-risk source* | 129 (56.3) | 89 (69.0) | 0.027 | 1.90 (1.1–3.26) | 101 (78.3) | 0.003 | 2.41 (1.35–4.29) | Respiratory | 75 (32.8) | 54 (72.0) | 0.042 | 1.88 (1.03–3.41) | 64 (85.3) | <0.001 | 3.42 (1.67–7.01) | Intra-abdomen | 54 (23.6) | 35 (64.8) | 0.749 | 1.14 (0.61–2.16) | 37 (68.5) | 0.736 | 0.90 (0.46–1.73) | Genitourinary | 47 (20.5) | 20 (14.0) | 0.002 | 0.36 (0.18–0.69) | 24 (51.0) | 0.002 | 0.34 (0.18–0.67) | Skin and soft tissue | 18 (7.9) | 11 (61.1) | 1.000 | 0.94 (0.35–2.53) | 12 (66.7) | 0.789 | 0.83 (0.30–2.32) | Monotherapy-inappropriate | 45 (19.65) | 28 (62.2) | 0.632 | 1.19 (0.58–2.45) | 32 (71.1) | 0.623 | 1.21 (0.56–2.61) | Monotherapy-appropriate | 100 (43.67) | 58 (58.0) | | | 67 (67.0) | | | Combination-inappropriate | 21 (9.17) | 16 (76.2) | 0.306 | 1.81 (0.58–5.60) | 17 (81.0) | 0.355 | 1.78 (0.53–6.03) | Combination-appropriate | 61 (26.64) | 39 (63.9) | | | 43 (70.5) | | |
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*Respiratory and Intra-abdominal [15, 16].
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