Pneumococcal pneumonia: differences according to blood culture results

BMC Pulmonary Medicine

Table 4 Comparison between in-hospital course and outcomes of patients hospitalized with pneumonia by Streptococcus pneumoniae according the blood culture results: adjusted analysis

	Odds ratio (95% CI)*	PValue
In-hospital course
Admission to intensive care unit	1 (0.7 – 1.4)	0.8
Use of mechanical ventilation	1.7 (1 – 3.1)	0.06
Septic shock^†	2.1 (1.2 – 3.5)	0.006
Treatment failure	1.4 (1 – 2.1)	0.06
Severe sepsis	1.1 (0.8 – 1.5)	0.4
Outcomes
In-hospital mortality	2.1 (1.1 – 3.9)	0.02
15-day mortality	3.6 (1.7 – 7.4)	0.0006
30-day mortality	2.7 (1.5 – 5)	0.002
30-day readmission	0.5 (0.2 – 1.1)	0.08
Length of hospital stay (days)^‡
Continuous	1.1 (1 – 1.2)^║	0.1
>3 days	1 (0.7 – 1.4)	0.8

CI, confidence interval.
^*Odds ratio adjusted by severity of illness on admission measured by CURB-65, and those characteristics of patients and variables related to process-of-care which were found statistically significant according to blood culture results, such as sex, congestive heart failure, alcoholism, pneumococcal vaccine in last 5 years, pleural effusion, appropriate antibiotic, antibiotics within 4 hours, dual antibiotic therapy including a macrolide, and antibiotic administration prior to hospital admission. Only significant adjusting variables were kept in each model.
^†Septic shock defined as arterial systolic blood pressure <90 mm Hg and need for vasopressors ≥ 4 hours.
^‡Deaths are excluded.
^║For the comparison of length of hospital stay as a continuous variable, the general linear model was used, and due to the skewed distribution of length of stay, the logarithmic transformation was applied. Hence, data are given as the exponential of the estimated beta parameter, indicating how many times longer the length of stay was among blood culture-positive than culture-negative patients with Streptococcus pneumoniae.

ISSN: 1471-2466