Volume 18, Number 7—July 2012
Research
Predicting Risk for Death from MRSA Bacteremia1
, Lawrence C. Kleinman, Eliesel G. Lacerda de la Cruz, and Stephen G. Jenkins
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.
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.