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Table 3 Propensity score adjustment among patients eligible for inotropic therapy during EGDT

From: In-hospital mortality following treatment with red blood cell transfusion or inotropic therapy during early goal-directed therapy for septic shock: a retrospective propensity-adjusted analysis

 

Inotropes (n = 186)

No inotropes (n = 207)

Pvalue (unadjusted)

Pvalue (adjusted for propensity score)

Demographics and comorbidities

Age, years

76 (67-84)

72 (61-81)

0.01

0.85

Female (%)

46.8

44.9

0.74

0.58

Race

 

0.45

0.47

White (%)

58.6

62.3

Asian (%)

15.1

11.6

Hispanic (%)

11.8

12.6

African-American (%)

6.4

8.2

Other (%)

8.0

5.3

Ischemic heart disease (%)

31.7

30.0

0.38

0.96

Congestive heart failure (%)

39.8

37.2

0.60

0.91

Chronic lung disease (%)

32.2

42.5

0.04

0.49

Diabetes (%)

34.4

34.8

0.94

0.29

HIV/AIDS (%)

0.5

1.0

0.63

0.66

Malignancy (%)

10.8

12.1

0.68

0.73

Rheumatologic disease (%)

4.8

6.3

0.54

0.57

Elixhauser score

16 (8-21)

15 (7-23)

0.64

0.38

Initial presenting variables

Systolic blood pressure, mm Hga

111 (94-130)

113 (95-132)

0.57

0.23

Diastolic blood pressure, mm Hga

65 (51-80)

66 (54-78)

0.51

0.31

Heart rate, bpma

108 (92-124)

108 (90-125)

0.80

0.50

Shock indexa

1.0 (0.8-1.2)

1.0 (0.8-1.1)

0.85

0.94

Shock index ≥ 1.0

52.7

50.2

0.63

0.74

Serum lactate, mmol/Lb

4.6 (3.4-6.2)

4.4 (3.0-6.2)

0.22

0.47

Positive initial blood cultures (%)

34.4

31.9

0.60

0.40

EGDT treatment period variables

Fluid administered by 6 hours, liters

4.0 (3.0-5.0)

3.5 (2.5-5.0)

0.03

0.34

Peak CVP, mm Hgb

16 (13-20)

17 (13-22)

0.27

0.45

Hemoglobin nadir, g/dLb

12.7 (11.6-14.0)

12.2 (10.9-13.7)

0.04

0.11

RBC transfusion (%)

0

0

n/a

n/a

Antibiotic therapy within one hour (%)

95.2

90.8

0.10

0.11

Mechanical ventilation (%)b

30.6

34.3

0.44

0.58

Vasopressor administration (%)b

71.5

42.5

<0.001

0.31

Initial ScvO2, percentb

62 (55-70)

64 (57-69)

0.44

0.07

Final ScvO2, percentb

68 (63-72)

68 (61-73)

0.29

0.62

Final ScvO2 > 70% (%)

44.4

42.3

0.68

0.80

Change in ScvO2, percent

5 (−2-13)

3(−4-10)

0.16

0.06

Lactate clearance, percent per hourb

8.2 (4.8-13.0)

8.5 (4.8-13.6)

0.40

0.38

Lactate clearance ≥5% per hour (%)

74.1

74.2

0.98

0.89

mSOFA score at 6 hours

5 (4-6)

4 (2-6)

<0.001

0.51

eSAPS 3 score

52 (46-58)

48 (43-55)

0.02

0.71

Post-treatment variables

mSOFA score at 24 hours

5 (4-7)

4 (3-6)

0.001

0.21

In-hospital mortality (%)

23.7

18.8

0.24

0.41

  1. A subgroup analysis was conducted among patients with a hemoglobin nadir of 10 g/dL or greater during EGDT. Unadjusted P values are reported for the observed variables based on whether inotropic therapy was administered for an ScvO2 less than 70%. Adjusted P values are based on bivariate regression analyses comparing the propensity score (for inotropic therapy) and each variable. Continuous values are presented as median values with interquartile ranges in parentheses. Dichotomous variables are presented as percentages.
  2. aAt initial emergency department presentation; bwithin the first six hours from shock recognition (time zero). ; EGDT, early goal-directed therapy; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; mm Hg, millimeters mercury; bpm, beats per minute; CVP, central venous pressure; g/dL, grams per deciliter; RBC, red blood cells; ScvO2, central venous oxygen saturation; mSOFA, modified sequential organ failure assessment score; eSAPS, electronic simplified acute physiology score.