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Table 3 Clinical endpoints overall and stratified by sepsis severity and use of sepsis support

From: Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in intensive care unit patients with infection and sepsis patients: a patient-level meta-analysis of randomized trials

  Control group PCT group Adjusted OR or difference (95% CI)a, p value p value for interaction
2230 2252
Overall     
 Antibiotic therapy (days) 10.4 ± 9.7 9.3 ± 9.2 −1.19 (−1.73 to −0.66), p < 0.001  
 30-day mortality 529 (23.7%) 475 (21.1%) 0.89 (0.8 to 0.99), p = 0.03  
 Length of hospital stay (days) 28.7 ± 27.9 28.6 ± 27.9 0.09 (−1.51 to 1.7), p = 0.908  
 Length of ICU stay (days) 14.7 ± 16.3 14.8 ± 16.5 0.04 (−0.9 to 0.99), p = 0.928  
Subgroup by sepsis definition
 Meeting sepsis 3 definition 1630 1605   
  Antibiotic therapy (days) 10.5 ± 9.2 9.3 ± 8.9 −1.22 (−1.82 to −0.62), p < 0.001 0.915
  30-day mortality 397 (24.4%) 338 (21.1%) 0.86 (0.76 to 0.98), p = 0.022 0.388
  Length of hospital stay (days) 29.5 ± 27.9 29.6 ± 29.4 0.07 (−1.89 to 2.03), p = 0.946 0.891
  Length of ICU stay (days) 14.1 ± 15.5 14.5 ± 17.0 0.37 (−0.74 to 1.48), p = 0.51 0.246
 Not meeting sepsis 3 definition 600 647   
  Antibiotic therapy (days) 10.2 ± 10.9 9.1 ± 9.9 −1.13 (−2.27 to 0.01), p = 0.052 0.915
  30-day mortality 132 (22.0%) 137 (21.2%) 0.96 (0.78 to 1.19), p = 0.717 0.388
  Length of hospital stay (days) 26.4 ± 27.9 26.2 ± 23.7 0.16 (−2.53 to 2.84), p = 0.909 0.891
  Length of ICU stay (days) 16.5 ± 18.3 15.6 ± 15.2 −0.82 (−2.65 to 1.01), p = 0.378 0.246
Subgroup by organ failure
 SOFA 0 to 6 763 776   
  Antibiotic therapy (days) 10.9 ± 10.3 8.1 ± 8.2 −2.62 (−3.51 to −1.73), p < 0.001 < 0.001
  30-day mortality 105 (13.8%) 91 (11.7%) 0.85 (0.66 to 1.1), p = 0.227 0.991
  Length of hospital stay (days) 28.6 ± 28.6 26.8 ± 25.8 −1.96 (−4.65 to 0.72), p = 0.152 0.138
  Length of ICU stay (days) 12.9 ± 16.7 12.1 ± 15.6 −0.92 (−2.52 to 0.69), p = 0.263 0.083
 SOFA 7 to 9 474 445   
  Antibiotic therapy (days) 10.1 ± 8.2 10.2 ± 9.4 0.01 (−1.1 to 1.11), p = 0.988 0.003
  30-day mortality 112 (23.6%) 96 (21.6%) 0.92 (0.73 to 1.17), p = 0.512 0.601
  Length of hospital stay (days) 30.7 ± 26.4 29.4 ± 25.9 −1.14 (−4.52 to 2.24), p = 0.508 0.543
  Length of ICU stay (days) 14.0 ± 14.3 14.1 ± 15.3 0.23 (−1.66 to 2.12), p = 0.813 0.862
 SOFA 10 to 24 486 486   
  Antibiotic therapy (days) 10.7 ± 9.1 10.0 ± 8.8 −0.63 (−1.71 to 0.45), p = 0.256 0.125
  30-day mortality 190 (39.1%) 161 (33.1%) 0.86 (0.72 to 1.01), p = 0.065 0.576
  Length of hospital stay (days) 29.4 ± 27.5 32.6 ± 35.5 3.21 (−0.76 to 7.18), p = 0.113 0.024
  Length of ICU stay (days) 15.6 ± 15.4 17.7 ± 19.2 2.08 (−0.08 to 4.24), p = 0.059 0.036
 No septic shock (no vasopressor use) 495 489   
  Antibiotic therapy (days) 11.2 ± 9.9 9.8 ± 9.2 −1.35 (−2.53 to −0.17), p = 0.025 0.586
  30-day mortality 79 (16.0%) 76 (15.5%) 0.97 (0.73 to 1.28), p = 0.823 0.512
  Length of hospital stay (days) 24.9 ± 26.3 23.2 ± 20.6 −1.49 (−4.35 to 1.38), p = 0.309 0.258
  Length of ICU stay (days) 13.2 ± 15.6 12.7 ± 14.2 −0.43 (−2.25 to 1.39), p = 0.642 0.47
 Septic shock (with vasopressor use) 1593 1606   
  Antibiotic therapy (days) 10.4 ± 9.8 9.3 ± 9.4 −1.03 (−1.68 to −0.39), p = 0.002 0.586
  30-day mortality 420 (26.4%) 376 (23.4%) 0.89 (0.79 to 1), p = 0.051 0.512
  Length of hospital stay (days) 30.1 ± 27.0 30.6 ± 26.3 0.6 (−1.23 to 2.43), p = 0.52 0.258
  Length of ICU stay (days) 15.0 ± 16.1 15.4 ± 17.0 0.34 (−0.8 to 1.49), p = 0.557 0.47
 No respiratory failure (invasive ventilation support) 672 651   
  Antibiotic therapy (days) 11.0 ± 11.4 9.5 ± 9.6 −1.43 (−2.49 to − 0.37), p = 0.008 0.467
  30-day mortality 104 (15.5%) 83 (12.7%) 0.83 (0.64 to 1.08), p = 0.158 0.633
  Length of hospital stay (days) 25.4 ± 21.7 25.3 ± 23.3 −0.01 (−2.33 to 2.31), p = 0.993 0.788
  Length of ICU stay (days) 11.7 ± 13.5 12.4 ± 14.2 0.53 (− 0.86 to 1.92), p = 0.456 0.433
 Respiratory failure (invasive ventilation support) 1434 1478   
  Antibiotic therapy (days) 10.2 ± 9.0 9.2 ± 9.2 −1.09 (−1.73 to −0.45), p = 0.001 0.467
  30-day mortality 401 (28.0%) 373 (25.2%) 0.89 (0.79 to 1), p = 0.058 0.633
  Length of hospital stay (days) 30.9 ± 30.9 30.3 ± 26.0 −0.39 (−2.42 to 1.65), p = 0.708 0.788
  Length of ICU stay (days) 16.2 ± 17.5 16.0 ± 17.5 −0.3 (−1.56 to 0.95), p = 0.637 0.433
 No renal replacement therapy 1463 1495   
  Antibiotic therapy (days) 9.4 ± 9.2 8.4 ± 8.6 −1.02 (−1.64 to −0.39), p = 0.001 0.475
  30-day mortality 301 (20.6%) 265 (17.7%) 0.86 (0.74 to 1), p = 0.046 0.553
  Length of hospital stay (days) 29.8 ± 31.1 28.4 ± 25.5 −1.41 (−3.4 to 0.59), p = 0.168 0.026
  Length of ICU stay (days) 14.6 ± 17.4 14.1 ± 15.9 −0.64 (−1.82 to 0.53), p = 0.284 0.077
 Renal replacement therapy 767 757   
  Antibiotic therapy (days) 12.3 ± 10.2 10.9 ± 10.0 −1.45 (−2.44 to −0.46), p = 0.004 0.475
  30-day mortality 228 (29.7%) 210 (27.7%) 0.96 (0.83 to 1.11), p = 0.584 0.553
  Length of hospital stay (days) 26.6 ± 20.5 29.1 ± 32.2 2.97 (0.31 to 5.63), p = 0.028 0.026
  Length of ICU stay (days) 14.9 ± 14.0 16.2 ± 17.5 1.43 (−0.16 to 3.02), p = 0.079 0.077
  1. Values are presented as mean ± standard deviation or n (%) as appropriate
  2. CI confidence interval, ICU intensive care unit, OR odds ratio, PCT procalcitonin, SOFA Sequential Organ Failure Assessment
  3. a Multivariable hierarchical regression with outcome of interest as dependent variable and trial as a random effect