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Volume 18, Number 7—July 2012

Research

Predicting Risk for Death from MRSA Bacteremia1

Mina PastagiaComments to Author , Lawrence C. Kleinman, Eliesel G. Lacerda de la Cruz, and Stephen G. Jenkins
Author affiliations: The Rockefeller University, New York, New York, USA (M. Pastagia); Mount Sinai School of Medicine, New York (L.C. Kleinman, E.G. Lacerda de la Cruz); and Weill Cornell School of Medicine, New York (S.G. Jenkins)

Main Article

Table 2

Multivariable analysis of risk factors for 90-day all-cause deaths among 603 patients with MRSA bacteremia, New York, New York, USA, 2002–2007*

Risk factor Odds ratio (95% CI) Adjusted risk ratio (95% CI) Adjusted risk difference† (95% CI)
Age‡ 1.72 (1.29 to 2.30) 1.34 (1.12 to 1.65) 0.04 (0.03 to 0.05)
Race/ethnicity
Black 0.71 (0.39 to 1.29) 0.85 (0.63 to 1.16) –0.04 (–0.04 to –0.11)
Hispanic 0.85 (0.45 to 1.58) 0.93 (0.66 to 1.23) –0.02 (–0.10 to 0.06)
Asian 1.83 (0.92 to 3.66) 1.30 (0.95 to 1.72) 0.08 (–0.01 to 0.18)
Concurrent condition
Diabetes 0.50 (0.31 to 0.83) 0.73 (0.57 to 0.93) –0.08 (–0.14 to –0.02)
Immunosuppressant use 0.83 (0.37 to 1.83) 0.92 (0.63 to 1.30) –0.02 (–0.10 to 0.08)
Liver cirrhosis 2.18 (1.16 to 4.12) 1.40 (1.04 to 1.77) 0.10 (0.01 to 0.19)
Renal insufficiency 1.89 (1.18 to 3.01) 1.33 (1.05 to 1.70) 0.08 (0.01 to 0.14)
Other
Infectious disease consultation 0.43 (0.26 to 0.69) 0.69 (0.57 to 0.86) –0.11 (–0.16 to –0.04)
History of MRSA infection 0.77 (0.45 to 1.34) 0.89 (0.70 to 1.13) –0.03 (–0.09 to 0.04)
Nursing home residence 3.08 (1.81 to 5.24) 1.62 (1.31 to 2.06) 0.15 (0.08 to 0.23)
Intensive care unit stay 1.71 (1.17 to 2.50) 1.29 (1.11 to 2.15) 0.07 (0.03 to 0.20)
Vasopressor use 15.44 (8.58 to 27.76) 3.67 (2.66 to 4.66) 0.48 (0.34 to 0.58)
Inappropriate antimicrobial drug therapy 1.38 (0.73 to 2.63) 1.15 (0.89 to 1.46) 0.04 (–0.03 to 0.12)
MRSA strain
VISA 0.58 (0.24 to 1.38) 0.78 (0.49 to 1.19) –0.06 (–0.15 to 0.05)
hVISA 1.23 (0.54 to 2.82) 1.10 (0.67 to 1.58) 0.03 (–0.09 to 0.16)
Infection source
Pneumonia 1.77 (0.85 to 3.64) 1.28 (0.91 to 1.68) 0.07 (–0.02 to 0.17)
Vascular graft infection 0.21 (0.03 to 1.70) 0.460 (0.005 to 0.940) –0.15 (–0.29 to –0.02)
Endocarditis 1.49 (0.80 to 2.79) 1.19 (0.87 to 1.51) 0.05 (–0.03 to 0.13)

*Results from logistic regression with outcomes and covariates. MRSA, methicillin-resistant Staphylococcus aureus.
VISA, vancomycin-intermediate S. aureus strains, hVISA, heteroresistant vancomycin-intermediate S. aureus strains.
†Adjusted risk difference refers to the absolute difference in risk; for example, an adjusted risk difference of 0.10 signifies a 10% increased risk for all-cause deaths given that variable.
‡Measures are adjusted odds ratio for a 10-y difference and adjusted risk difference for effect of age 50–60 y.

Main Article

1Parts of the data in this article were presented at the 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy/Infectious Diseases Society of America Meeting, October 25–28, 2008, Washington, DC, USA; and the 19th European Congress of Clinical Microbiology and Infectious Diseases Meeting, May 16–19, 2009, Helsinki, Finland.

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