1Department of Emergency Medicine, Gachon University, Gil Medical Center, Incheon, Korea
2Department of Family Medicine, Gachon University, Gil Medical Center, Incheon, Korea
3Department of Neurology, Gachon University, Gil Medical Center, Incheon, Korea
Copyright © 2015 The Korean Society of Critical Care Medicine
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Data were number (%) or mean ± standard deviaiton.
CVP: central venous pressure; APACHE II: acute physiology and chronic health evaluation II; Hb: hemoglobin; WBC: white blood cell; PLT: platelet; INR: international normalized ratio; CRP: C-reactive protein; Cr: creatinine; AST: aspartate aminotransferase; ALT: alanine transaminase; LDH: lactate dehydrogenase; CPK: creatine phosphokinase; CK-MB: creatine kinase MB isoenzyme; pH: power of hydrogen, PCO2: partial pressure of carbon dioxide; PO2: partial pressure of oxygen; HCO3: bicarbonate; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; Tbc: tuberculosis; AIDS: acquired immune deficiency syndrome.
Univariate |
Stepwise multivariate* |
|||
---|---|---|---|---|
OR (95% CI) | p-value | Adjusted OR (95% CI) | p-value | |
Elderly (> 70 years) | 2.14 (1.40–3.26) | < 0.001 | 2.42 (1.35–4.32) | 0.003 |
Vital sign | ||||
SBP < 80 mmHg | 1.64 (1.05–2.55) | 0.030 | ||
DBP < 50 mmHg | 1.62 (1.06–2.46) | 0.026 | ||
HR > 100/min | 1.65 (1.09–2.50) | 0.017 | ||
Increased APACHE II (per 1 point) | 1.06 (1.03–1.08) | < 0.001 | 1.04 (1.01–1.08) | 0.005 |
Longer time to anti start at ER (> 4 h) | 0.61 (0.40–0.92) | 0.019 | ||
Laboratory finding | ||||
Leukopenia (WBC < 4000) | 3.66 (1.80–7.44) | < 0.001 | 3.63 (1.48–8.94) | 0.005 |
Prolonged PT-INR (> 1.2) | 1.93 (1.27–2.93) | 0.002 | 2.53 (1.41–4.54) | 0.002 |
LDH > 485 | 1.77 (1.16–2.70) | 0.008 | ||
Acidosis (PH < 7.35) | 2.48 (1.61–3.82) | < 0.001 | ||
Hypoxemia (PO2 < 83) | 1.78 (1.04–3.04) | 0.036 | 2.88 (1.30–6.38) | 0.009 |
Acidosis (HCO3 < 18) | 1.69 (1.08–2.65) | 0.021 | ||
Lactate (> 4.0 mmol/L) | 3.55 (2.22–5.66) | < 0.001 | ||
Positive culture | 2.39 (1.45–3.95) | 0.001 |
All presented variables are significant (p < 0.05).
*Included significant variables in the univariate analysis (p < 0.05).
OR: odds ratio; CI: confidence interval; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; APACHE II: acute physiology and chronic health evaluation II; ER: emergency room; WBC: white blood cell; PT: prothrombin time; INR: international normalized ratio; LDH: lactate dehydrogenase.
Total (N = 398) | Survived (n = 253) | Dead (n = 145) | p-value | |
---|---|---|---|---|
Age (years) | 69.3 ± 14.2 | 66.8 ± 14.6 | 73.6 ± 12.3 | < 0.001 |
Sex (female) | 137 (34.4) | 82 (32.4) | 55 (37.9) | 0.265 |
Vital signs | ||||
Systolic blood pressure (mmHg) | 79.4 ± 15.9 | 81.3 ± 13.2 | 76.1 ± 19.5 | 0.002 |
Diastolic blood pressure (mmHg) | 48.1 ± 13.8 | 49.8 ± 11.9 | 45.0 ± 16.2 | < 0.001 |
Heart rate (/min) | 101.9 ± 27.0 | 99.6 ± 25.5 | 106.0 ± 29.2 | 0.024 |
Respiratory rate (/min) | 22.8 ± 6.1 | 22.9 ± 5.7 | 22.6 ± 6.7 | 0.646 |
Body temperature (oC) | 36.6 ± 4.2 | 36.8 ± 3.5 | 36.3 ± 5.3 | 0.212 |
CVP (n = 305) | 11.4 ± 7.2 | 11.2 ± 6.8 | 11.6 ± 7.7 | 0.595 |
APACHE II (n = 284) | 24.3 ± 9.7 | 22.3 ± 9.5 | 27.2 ± 9.4 | < 0.001 |
Laboratory results | ||||
Hb | 11.2 ± 2.5 | 11.4 ± 2.5 | 10.7 ± 2.5 | 0.006 |
WBC | 13.7 ± 10.0 | 14.0 ± 7.8 | 13.2 ± 12.9 | 0.420 |
PLT | 217.8 ± 121.9 | 224.6 ± 115.5 | 205.9 ± 131.9 | 0.140 |
INR | 1.32 ± 0.56 | 1.27 ± 0.46 | 1.42 ± 0.69 | 0.009 |
CRP | 13.9 ± 9.2 | 13.2 ± 9.3 | 15.1 ± 9.1 | 0.053 |
Cr | 1.47 ± 1.10 | 1.42 ± 1.13 | 1.55 ± 1.04 | 0.249 |
AST | 74.3 ± 248.6 | 74.1 ± 300.4 | 74.5 ± 111.6 | 0.987 |
ALT | 45.8 ± 154.3 | 46.5 ± 184.8 | 44.5 ± 78.3 | 0.901 |
LDH | 669.5 ± 846.5 | 610.1 ± 953.1 | 767.8 ± 622.7 | 0.086 |
CPK | 347.9 ± 900.2 | 339.2 ± 945.1 | 362.4 ± 822.5 | 0.814 |
CK-MB (n = 317) | 6.17 ± 15.11 | 5.47 ± 15.74 | 7.30 ± 14.02 | 0.295 |
Troponin-I (n = 318) | 0.38 ± 2.87 | 0.47 ± 3.62 | 0.24 ± 0.51 | 0.506 |
PH | 7.38 ± 0.13 | 7.39 ± 0.13 | 7.35 ± 0.15 | 0.003 |
PCO2 | 36.8 ± 15.7 | 36.2 ± 15.1 | 37.7 ± 16.6 | 0.382 |
PO2 | 67.4 ± 35.4 | 72.1 ± 37.6 | 59.1 ± 29.6 | < 0.001 |
HCO3 | 21.5 ± 6.9 | 21.9 ± 6.4 | 20.7 ± 7.7 | 0.110 |
Lactate | 3.3 ± 3.0 | 2.7 ± 2.7 | 4.3 ± 3.3 | < 0.001 |
Positive culture | 79 (20.0) | 37 (14.7) | 42 (29.2) | 0.001 |
Comorbid disease | ||||
Stroke | 6 (1.5) | 2 (0.8) | 4 (2.8) | 0.121 |
Hypertension | 135 (33.9) | 84 (33.2) | 51 (35.2) | 0.689 |
DM | 92 (23.1) | 60 (23.7) | 32 (22.1) | 0.708 |
Asthma | 16 (4.0) | 11 (4.4) | 5 (3.5) | 0.660 |
COPD | 34 (8.5) | 21 (8.3) | 13 (9.0) | 0.819 |
Tbc | 57 (14.3) | 31 (12.3) | 26 (17.9) | 0.120 |
AIDS | 3 (0.8) | 1 (0.4) | 2 (1.4) | 0.275 |
From symptom to antibiotics start, h | 59.1 ± 123.0 | 56.3 ± 114.9 | 64.0 ± 136.3 | 0.552 |
From ER visit to antibiotics start, h | 5.3 ± 3.3 | 5.3 ± 3.0 | 5.3 ± 3.8 | 0.940 |
Univariate |
Stepwise multivariate |
|||
---|---|---|---|---|
OR (95% CI) | p-value | Adjusted OR (95% CI) | p-value | |
Elderly (> 70 years) | 2.14 (1.40–3.26) | < 0.001 | 2.42 (1.35–4.32) | 0.003 |
Vital sign | ||||
SBP < 80 mmHg | 1.64 (1.05–2.55) | 0.030 | ||
DBP < 50 mmHg | 1.62 (1.06–2.46) | 0.026 | ||
HR > 100/min | 1.65 (1.09–2.50) | 0.017 | ||
Increased APACHE II (per 1 point) | 1.06 (1.03–1.08) | < 0.001 | 1.04 (1.01–1.08) | 0.005 |
Longer time to anti start at ER (> 4 h) | 0.61 (0.40–0.92) | 0.019 | ||
Laboratory finding | ||||
Leukopenia (WBC < 4000) | 3.66 (1.80–7.44) | < 0.001 | 3.63 (1.48–8.94) | 0.005 |
Prolonged PT-INR (> 1.2) | 1.93 (1.27–2.93) | 0.002 | 2.53 (1.41–4.54) | 0.002 |
LDH > 485 | 1.77 (1.16–2.70) | 0.008 | ||
Acidosis (PH < 7.35) | 2.48 (1.61–3.82) | < 0.001 | ||
Hypoxemia (PO2 < 83) | 1.78 (1.04–3.04) | 0.036 | 2.88 (1.30–6.38) | 0.009 |
Acidosis (HCO3 < 18) | 1.69 (1.08–2.65) | 0.021 | ||
Lactate (> 4.0 mmol/L) | 3.55 (2.22–5.66) | < 0.001 | ||
Positive culture | 2.39 (1.45–3.95) | 0.001 |
Data were number (%) or mean ± standard deviaiton. CVP: central venous pressure; APACHE II: acute physiology and chronic health evaluation II; Hb: hemoglobin; WBC: white blood cell; PLT: platelet; INR: international normalized ratio; CRP: C-reactive protein; Cr: creatinine; AST: aspartate aminotransferase; ALT: alanine transaminase; LDH: lactate dehydrogenase; CPK: creatine phosphokinase; CK-MB: creatine kinase MB isoenzyme; pH: power of hydrogen, PCO2: partial pressure of carbon dioxide; PO2: partial pressure of oxygen; HCO3: bicarbonate; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; Tbc: tuberculosis; AIDS: acquired immune deficiency syndrome.
All presented variables are significant (p < 0.05). Included significant variables in the univariate analysis (p < 0.05). OR: odds ratio; CI: confidence interval; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; APACHE II: acute physiology and chronic health evaluation II; ER: emergency room; WBC: white blood cell; PT: prothrombin time; INR: international normalized ratio; LDH: lactate dehydrogenase.