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Table 5 Multivariate analysis of factors associated with the use of crystalloid, colloid or blood for fluid resuscitation episodes*

From: Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units

  OR (95%CI) crystalloid given   OR (95%CI) colloid given   OR (95%CI) blood given  
Characteristic   P -value   P -value   P -value
Age (per one year increase) 1.00 (0.99 to 1.00)   1.00 (1.00 to 1.01)   1.00 (0.99 to 1.01)  
Study region       
Canada 1.00   1.00   1.00  
Australia 0.69 (0.42 to 1.11)   1.33 (0.88 to 2.02)   1.79 (1.00 to 3.23)  
China 0.46 (0.30 to 0.69) < 0.001 1.72 (1.20 to 2.47) 0.003 3.33 (2.02 to 5.50) < 0.001
Denmark 0.50 (0.27 to 0.94)   1.43 (0.83 to 2.48)   4.09 (2.03 to 8.25) < 0.001
France 1.60 (0.96 to 2.66)   0.82 (0.51 to 1.32)   0.88 (0.43 to 1.78)  
Germany 1.62 (1.08 to 2.44)   0.79 (0.54 to 1.14)   1.07 (0.62 to 1.84)  
Great Britain 0.18 (0.10 to 0.32) < 0.001 4.72 (2.99 to 7.44) < 0.001 0.93 (0.51 to 1.73)  
Hong Kong 0.88 (0.44 to 1.74)   0.93 (0.51 to 1.72)   1.17 (0.47 to 2.93)  
Italy 2.06 (1.28 to 3.31) 0.003 1.33 (0.86 to 2.06)   1.10 (0.59 to 2.03)  
New Zealand 3.43 (1.71 to 6.84) < 0.001 0.39 (0.21 to 0.74) 0.004 0.48 (0.19 to 1.24)  
Sweden 0.43 (0.23 to 0.80) 0.008 1.67 (0.99 to 2.82)   4.99 (2.58 to 9.63) < 0.001
Switzerland 0.96 (0.48 to 1.92)   1.12 (0.60 to 2.10)   1.18 (0.49 to 2.82)  
USA 2.55 (1.36 to 4.79) 0.004 0.16 (0.08 to 0.33) < 0.001 3.81 (1.78 to 8.17) 0.001
Other European 1.01 (0.59 to 1.72)   1.26 (0.77 to 2.05)   2.27 (1.17 to 4.39)  
Other countries 2.52 (1.46 to 4.33) 0.001 0.53 (0.32 to 0.89)   1.43 (0.70 to 2.93)  
Admission source       
Operating room after elective surgery 1.00   1.00   1.00  
Hospital floor 1.26 (0.91 to 1.75)   1.05 (0.80 to 1.38)   0.59 (0.41 to 0.84) 0.003
Transfer from other ICU or hospital 1.49 (1.03 to 2.15)   0.80 (0.58 to 1.11)   0.60 (0.39 to 0.91)  
Operating room after emergency surgery 1.57 (1.12 to 2.20) 0.008 0.93 (0.69 to 1.24)   0.58 (0.39 to 0.86) 0.006
Emergency room 2.16 (1.56 to 2.99) < 0.001 0.67 (0.50 to 0.90) 0.008 0.50 (0.34 to 0.75) 0.001
Hospital floor after previous ICU stay 1.12 (0.75 to 1.67)   1.18 (0.83 to 1.67)   0.62 (0.39 to 0.99)  
Trauma at hospital admission       
No trauma 1.00   1.00   1.00  
Trauma without brain injury 0.93 (0.64 to 1.35)   1.02 (0.73 to 1.42)   1.26 (0.82 to 1.95)  
Trauma with brain injury 1.13 (0.69 to 1.84)   1.05 (0.68 to 1.64)   1.15 (0.63 to 2.08)  
Sepsis in 24 hrs prior to survey date       
No sepsis 1.00   1.00   1.00  
Sepsis 0.90 (0.71 to 1.15)   1.26 (1.02 to 1.55)   0.67 (0.51 to 0.89) 0.005
Number of days in ICU at survey date       
0 days 1.00   1.00   1.00  
> 0 days 0.70 (0.56 to 0.87) 0.001 1.28 (1.05 to 1.56)   0.91 (0.70 to 1.19)  
Indication for fluid       
Impaired perfusion or low cardiac output 1.00   1.00   1.00  
Anaemia/bleeding/coagulopathy 0.15 (0.12 to 0.20) < 0.001 0.13 (0.10 to 0.17) < 0.001 26.7 (20.2 to 35.4) < 0.001
Other fluid losses 0.90 (0.60 to 1.37)   0.83 (0.55 to 1.23)   0.90 (0.54 to 1.49)  
Unit protocol 0.72 (0.52 to 1.01)   1.65 (1.21 to 2.25) 0.002 0.44 (0.29 to 0.67) < 0.001
Abnormal vital signs 0.93 (0.78 to 1.11)   1.34 (1.12 to 1.60) 0.001 0.34 (0.25 to 0.44) < 0.001
Other 0.39 (0.26 to 0.59) < 0.001 1.70 (1.18 to 2.45) 0.004 0.74 (0.47 to 1.18)  
Fluid prescriber       
ICU Specialist/consultant 1.00   1.00   1.00  
ICU Registrar 0.88 (0.71 to 1.09)   1.10 (0.90 to 1.34)   0.83 (0.64 to 1.08)  
ICU Resident/junior staff 1.19 (0.95 to 1.49)   1.04 (0.83 to 1.29)   0.72 (0.53 to 0.96)  
Other 1.36 (1.05 to 1.76)   1.12 (0.87 to 1.45)   0.60 (0.42 to 0.85) 0.004
Cardiovascular dysfunction       
SOFA < 3 1.00   1.00   1.00  
SOFA 3 to 4 0.94 (0.77 to 1.14)   1.08 (0.89 to 1.29)   1.26 (0.99 to 1.61)  
Respiratory failure       
SOFA < 3 1.00   1.00   1.00  
SOFA 3 to 4 0.87 (0.72 to 1.06)   1.10 (0.92 to 1.33)   1.02 (0.80 to 1.31)  
Renal replacement therapy       
No 1.00   1.00   1.00  
Yes 0.81 (0.59 to 1.11)   0.81 (0.60 to 1.08)   1.86 (1.29 to 2.68) 0.001
Mechanical ventilation       
No 1.00   1.00   1.00  
Yes 0.91 (0.75 to 1.12)   1.02 (0.85 to 1.23)   1.32 (1.02 to 1.71)  
Low filling pressure       
No 1.00   1.00   1.00  
Yes 1.26 (1.02 to 1.55)   0.86 (0.70 to 1.05)   1.08 (0.83 to 1.40)  
Heart rate (per 10 b/min increase) 1.05 (1.01 to 1.09)   0.98 (0.95 to 1.02)   1.01 (0.96 to 1.06)  
Mean arterial pressure 0.97 (0.93 to 1.02)   1.16 (1.11 to 1.21) < 0.001 0.85 (0.80 to 0.91) < 0.001
(per 10 mmHg decrease)       
Haemoglobin (per 10 g/L decrease) 0.97 (0.93 to 1.01)   0.94 (0.91 to 0.98) 0.004 1.24 (1.18 to 1.30) < 0.001
% 100+ 1.00   1.00   1.00  
% 80 to 99 0.91 (0.75 to 1.10)   0.92 (0.77 to 1.10)   1.80 (1.39 to 2.31) < 0.001
% 70 to 79 0.72 (0.54 to 0.98)   0.89 (0.68 to 1.18)   3.24 (2.29 to 4.57) < 0.001
% < 70 0.75 (0.52 to 1.09)   0.60 (0.43 to 0.84) 0.004 5.74 (3.84 to 8.58) < 0.001
Creatinine       
(per 10 umol/L increase) 1.00 (1.00 to 1.01)   1.00 (0.99 to 1.00)   1.00 (1.00 to 1.01)  
< 170 umol/L 1.00   1.00   1.00  
170+umol/L 0.86 (0.66 to 1.11)   1.00 (0.79 to 1.26)   1.22 (0.91 to 1.63)  
Chronic health points immunocompromised      
No 1.00   1.00   1.00  
Yes 0.64 (0.44 to 0.93)   1.32 (0.96 to 1.83)   0.96 (0.64 to 1.45)  
APACHE II 24 hrs prior to fluid administration      
per 1 point increase in score 1.01 (1.00 to 1.03)   0.99 (0.98 to 1.01)   1.01 (0.99 to 1.02)  
< 16 1.00   1.00   1.00  
16+ 1.13 (0.91 to 1.41)   0.88 (0.72 to 1.07)   1.30 (1.00 to 1.68)  
Lactate** (mmol/L)       
< 2 1.00   1.00   1.00  
2+ 1.02 (0.82 to 1.26)   0.90 (0.74 to 1.11)   1.59 (1.21 to 2.08) 0.001
Urine output** (ml/kg/hr)       
per ml/kg/hr 1.03 (1.00 to 1.06)   1.03 (0.99 to 1.06)   0.98 (0.93 to 1.02)  
< 0.5 1.00   1.00   1.00  
0.5+ 0.89 (0.72 to 1.09)   1.10 (0.89 to 1.35)   1.03 (0.77 to 1.38)  
Total fluid output** (ml/kg/hr)       
per ml/kg/hr 1.01 (0.99 to 1.02)   1.01 (0.99 to 1.03)   1.01 (0.98 to 1.03)  
< 1 1.00   1.00   1.00  
1+ 1.17 (0.95 to 1.43)   1.03 (0.85 to 1.24)   1.02 (0.79 to 1.33)  
  1. P-values highlighted where < 0.01
  2. Analyses include 4,430 episodes and 1939 study participants as data were lost due to missing values which could not be included in the multivariate analysis due to small numbers in cells. This number represents a loss of 1.5% of episodes and 1.1% of study participants.
  3. **Variables have > 10% missing values