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Table 3 Time to event analyses among CLC residents with UTI receiving potentially suboptimal and optimal antibiotic treatment

From: Poor clinical outcomes associated with suboptimal antibiotic treatment among older long-term care facility residents with urinary tract infection: a retrospective cohort study

 

Median time in days to event for residents who received potentially suboptimal treatment

(n = 12,718)

Median time in days to event for residents who received potentially optimal treatment

(n = 6983)

Unadjusted HR (95% CI)

Adjusted HR (95% CI)

Poor clinical outcomea

10 (4–18.5)

11 (5–19)

1.05 (1.00–1.10)

1.06 (1.01–1.11)

 Hospitalization/ Emergency department visitb

11 (4–20)

12 (5–20)

0.99 (0.93–1.06)

1.02 (0.96–1.10)

 UTI recurrencec

13 (7–21)

14 (8–21)

0.93 (0.86–1.01)

0.97 (0.89–1.05)

 All-cause mortalityd

9 (3–18)

9 (3–18)

1.11 (1.02–1.22)

1.05 (0.95–1.15)

 Clostridioides difficile infectione

10 (3–17)

11 (5–17)

2.03 (1.62–2.54)

1.94 (1.54–2.44)

 Antibiotic related adverse drug eventf

6 (1–15)

11 (3–18)

0.89 (0.48–1.64)

0.93 (0.51–1.72)

  1. CI Confidence interval, CLC Community Living Center, HR Hazard ratio, UTI Urinary tract infection, VAMC Veterans Affairs Medical Center
  2. All covariates were included as dichotomous variables representing presence as compared to absence of the characteristic of interest, unless otherwise noted. Age was included as a categorical variable (≥ 85, 75–84, 65–74 years) as compared to < 65 years. Recent high WBC was included as a WBC > 10 × 103/μL within 7 days prior to treatment as compared to a measurement below or missing. Total CLC incident UTI rate per 10,000 bed days was included as a continuous variable. Year of episode was included as a discrete variable for each year
  3. aAdjusted for 8 resident-level covariates (genitourinary disease comorbidity, cardiopulmonary comorbidity, chronic renal disease comorbidity, previous fluroquinolone exposure in the past 30 days, age, previous VAMC hospitalization in the past 30 days, previous VAMC urine culture in the past 365 days, high white blood cell count), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  4. bAdjusted for 10 resident-level covariates (cardiopulmonary comorbidity, genitourinary disease comorbidity, chronic renal disease comorbidity, age, previous VAMC hospitalization in the past 30 days, previous outpatient VA urine culture in the past 365 days, previous CLC urine culture in the past 365 days, previous VAMC urine culture in the past 365 days, high white blood cell count, year of episode) and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  5. cAdjusted for 5 resident-level covariates (genitourinary disease comorbidity, previous fluroquinolone exposure in the past 30 days, previous fluroquinolone resistant culture in the past 365 days, previous CLC urine culture in the past 365 days, previous VAMC urine culture in the past 365 days), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  6. dAdjusted for 10 resident-level covariates (history of a skin infection diagnosis in the past 365 days, history of a urinary tract infection diagnosis in the past 365 days, chronic renal disease comorbidity, age, previous fluroquinolone exposure in the past 30 days, previous VAMC hospitalization in the past 30 days, previous outpatient VA urine culture in the past 365 days, previous VAMC urine culture in the past 365 days, high white blood cell count, year of episode), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  7. eAdjusted for 8 resident-level covariates (history of a skin infection diagnosis in the past 365 days, genitourinary disease comorbidity, chronic renal disease comorbidity, previous VAMC hospitalization in the past 30 days, previous CLC urine culture in the past 365 days, previous VAMC urine culture in the past 365 days, high white blood cell count, year of episode), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  8. fAdjusted for 2 resident-level covariates (VAMC hospitalization in the past 30 days, year of episode), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  9. All covariates were included in adjusted models as dichotomous variables representing presence as compared to absence of the characteristic of interest, unless otherwise noted. Age was included as a categorical variable (≥ 85, 75–84, 65–74 years) as compared to < 65 years. Recent high WBC was included as a WBC > 10 × 103/μL within 7 days prior to treatment as compared to a measurement below or missing. Total CLC incident UTI rate per 10,000 bed days was included as a continuous variable. Year of episode was included as a discrete variable for each year