Heterogeneity of Benefit from Earlier Time-to-Antibiotics for Sepsis
Authors' conclusion
In patients with community-onset sepsis, the mortality benefit of shorter time-to-antibiotics varied by patient characteristics.
Study context
- Population
- Patients hospitalised with community-onset sepsis at 173 hospitals, treated with antimicrobials within 12 hours
- Participants
- 273,255 patients · 173 hospitals
- Exposure
- Shorter vs longer time-to-antibiotics
- Shortern = 131,094
- Outcome
- Heterogeneity of benefit (absolute reduction in 30-day mortality) from shorter time-to-antibiotics by patient characteristics
- Follow-up
- 30 days
Methodological detailsmulticentre, causal forest, multivariable Poisson regression, spline analysis
- Multicentre
- Causal forest
- Multivariable Poisson regression
- Spline analysis
Main finding
As reported in the abstract
Absolute 30-day mortality reduction with shorter time-to-antibiotics, by subgroup (Poisson models)
Absolute mortality reduction
5.0% vs 0.4%
95% CI 4.3–5.7 vs 0.2–0.6P < 0.001
Metastatic cancer vs No cancer
Absolute mortality reduction
7.0% vs 2.8%
95% CI 5.8–8.2% vs 2.7–3.5%P = 0.005
Shock vs No shock
Absolute mortality reduction
4.8% vs 0.5%
95% CI 3.9–5.6% vs 0.3–0.8P < 0.001
≥3 organ dysfunctions vs 1 organ dysfunction
Observational data: associations, not effects.
Original publication
Heterogeneity of Benefit from Earlier Time-to-Antibiotics for Sepsis. Am J Respir Crit Care Med. Published 1 April 2024. doi:10.
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