Association between delay in intensive care unit admission and the host response in patients with community-acquired pneumonia

Pereverzeva, Liza; Uhel, Fabrice; Peters Sengers, Hessel; Cremer, Olaf L.; Schultz, Marcus J.; Bonten, Marc M. J.; Scicluna, Brendon P.; van der Poll, Tom

doi:10.1186/s13613-021-00930-5

Annals of Intensive Care

Table 1 Baseline characteristics and outcomes

From: Association between delay in intensive care unit admission and the host response in patients with community-acquired pneumonia

	Direct ICU admission	Delayed ICU admission	P value
Patients	387	143
Demographics
Age, years, median [IQR]	62 [49, 72]	64 [51, 73]	.47
Gender male, n (%)	252 (65.1)	83 (58.0)	.26
White race, n (%)	344 (88.9)	123 (86.0)	.45
Readmission^a, n (%)	11 (2.8)	3 (2.1)	.87
Chronic comorbidity, n (%)
None	110 (28.4)	35 (24.5)	.43
Immunocompromised state	82 (21.2)	50 (35.0)	.002
Cardiovascular insufficiency	110 (28.4)	32 (22.4)	.20
Malignancy	52 (13.4)	33 (23.1)	.011
Renal insufficiency	41 (10.6)	19 (13.3)	.48
Respiratory insufficiency	114 (29.5)	35 (24.5)	.31
COPD	82 (21.2)	26 (18.2)	.52
Diabetes mellitus	86 (22.2)	24 (16.8)	.21
Charlson comorbidity index	4 [2, 6]	4 [3, 6]	.18
Vital signs on admission, median [IQR]
Temperature	38 [37, 38]	38 [37, 39]	.14
PaO₂/FiO₂ ratio	114 [57, 477]	102 [50, 351]	.21
PEEP during first 24 h, cm H₂O	24 [7, 25]	24 [6, 24]	.47
Severity of disease on ICU admission
APACHE IV Score, median [IQR]	75 [59, 98]	75 [60, 92]	.75
SOFA total, median [IQR]	6 [4, 8]	6 [4, 8]	.69
Mechanical ventilation, n (%)	303 (78.3)	101 (70.6)	.08
Shock, n (%)	179 (46.6)	48 (33.6)	.010
Acute kidney injury, n (%)	121 (31.3)	36 (25.2)	.21
Acute respiratory distress syndrome, n (%)	95 (24.5)	36 (25.2)	.97
Acute myocardial infarction, n (%)	14 (3.6)	3 (2.1)	.55
Causative pathogens			.08
Gram-positive bacteria	68 (17.6)	17 (11.9)
Gram-negative bacteria	57 (14.7)	24 (16.8)
Atypical bacteria	1 (0.3)	1 (0.7)
Virus	16 (4.1)	12 (8.4)
Fungi	11 (2.8)	10 (7.0)
Other pathogens	1 (0.3)	1 (0.7)
Multiple pathogens	42 (10.9)	11 (7.7)
Unknown	191 (49.4)	67 (46.9)
Outcome
Length of ICU stay, days, median [IQR]	5 [3, 9]	5 [2, 9]	.79
Length of hospital stay, days, median [IQR]	12 [16, 24]	14 [7, 24]	.21
MV characteristics
Duration of initial MV, days, median [IQR]	2 [1, 6]	2 [1, 6]	.34
Recurrence of MV, n (%)	10 (2.6)	10 (7.0)	.035
MV-free days^b, median [IQR]	22 [5, 26]	21 [5, 25]	.39
ICU-acquired complications, n (%)
None	327 (84.5)	122 (85.3)	.92
Acute kidney injury	35 (9.0)	11 (7.7)	.75
Acute respiratory distress syndrome	22 (5.7)	7 (4.9)	.89
Infection	25 (6.5)	11 (7.7)	.76
Mortality^c, n (%)
ICU	71 (18.9)	27 (19.3)	> .99
Hospital	101 (26.9)	46 (32.9)	.22
30 days	107 (28.5)	44 (31.4)	.58
60 days	123 (32.7)	53 (37.9)	.32
90 days	129 (34.3)	61 (43.6)	.07
1 year	158 (42.0)	71 (50.7)	.10

APACHE Acute Physiology and Chronic Health Evaluation, COPD chronic obstructive pulmonary disease, ED emergency department, FiO₂ fraction of inspired oxygen, ICU intensive care unit, IQR interquartile range, MV mechanical ventilation, PaO₂ partial pressure of oxygen in arterial blood gas analysis, PEEP positive end-expiratory pressure, SOFA Sequential Organ Failure Assessment
^aReadmissions > 30 days after hospital discharge
^bDays alive and free from MV on day 28 of ICU stay
^cMortality was calculated using the first ICU-admission for each patient; readmissions were not included in this analysis

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