Patient characteristics
| Total cohort | LUMC | RH | ASZ | |
| Demographics | ||||
| n (833) | 833 | 552 | 181 | 100 |
| Age, mean (SD) (833) | 78.4 (6.3) | 77.3 (5.7) | 80.7 (6.8) | 80.0 (7.0) |
| Gender (male), n (%) (833) | 520 (62.4) | 351 (63.5) | 113 (62.4) | 56 (56.0)) |
| Comorbidities, n (%) | ||||
| COPD (831) | 205 (24.6) | 117 (21.2) | 69 (38.1) | 19 (19.0) |
| Chronic heart disease (832) | 222 (26.7) | 157 (28.4) | 20 (11.0) | 45 (45.0) |
| Liver disease (832) | 21 (2.5) | 16 (2.9) | 3 (1.7) | 2 (2.0) |
| Renal disease (832) | 168 (20.2) | 113 (20.5) | 31 (17.1) | 24 (24.0) |
| Nursing home (831) | 96 (11.5) | 60 (10.8) | 29 (16.0) | 7 (7.0) |
| Immune-compromised (831) | 238 (28.6) | 181 (32.8) | 35 (19.3) | 22 (22.0) |
| Malignancy – (832)* | 99 (11.9) | 62 (11.2) | 24 (13.3) | 13 (13.0) |
| Malignancy + (830)* | 106 (12.7) | 77 (13.9) | 18 (9.9) | 11 (11.0) |
| DNR status, n (%) (827) | 322 (38.7) | 170 (30.7) | 103 (56.9) | 49 (49.0) |
| Disease severity | ||||
| Total PIRO score, median (IQR) (833) | 13 (9–16) | 12 (8–15) | 14 (11–16) | 13 (10–15) |
| Admission to MCU/ICU corrected for DNR status, n (%)† (824) | 66 (7.9) | 52 (9.4) | 8 (4.4) | 6 (6.0) |
| Suspected source of infection, n (%)‡ (833) | ||||
| Pulmonary | 475 (57.0) | 297 (53.8) | 121 (66.9) | 57 (57.0) |
| Urogenital | 296 (35.5) | 185 (33.5) | 76 (42.0) | 35 (35.0) |
| Abdominal | 131 (15.7) | 88 (15.9) | 28 (15.5) | 15 (15.0) |
| Skin | 59 (7.1) | 39 (7.1) | 9 (5.0) | 11 (11.0) |
| Neurological | 16 (1.9) | 8 (1.4) | 5 (2.8) | 3 (3.0) |
| Other | 98 (11.8) | 62 (11.2) | 27 (14.9) | 9 (9.0) |
| Vital signs on admission | ||||
| Systolic BP, mean (SD) (780) | 136 (29) | 135 (28) | 140 (31) | 131 (31) |
| Diastolic BP, mean (SD) (780) | 73 (17) | 72 (16) | 75 (18) | 72 (19) |
| Mean arterial pressure, mean (SD) (780) | 93.6 (18.8) | 93 (18) | 97 (20) | 92 (21) |
| HR, mean (SD) (814) | 104 (21) | 104 (21) | 104 (20) | 102 (19) |
| RR, mean (SD) (713) | 26 (7) | 24 (7) | 30 (8) | 25 (6) |
| Oxygen saturation, mean (SD) (805) | 94 (5) | 95 (5) | 92 (5) | 94 (5) |
| Temperature (°C), mean (SD) (795) | 38.7 (1.2) | 38.7 (1.2) | 38.5 (1.3) | 38.7 (0.9) |
| Altered mental status, n (%) (729) | 226 (27.1) | 139 (25.2) | 54 (29.8) | 33 (33.0) |
| Treatment variables | ||||
| Time to antibiotics (min), median (IQR) (833) | 91 (51–152) | 104 (64–163) | 52 (32–86) | 85 (19–206) |
| Fluid resuscitation (L), median (IQR) (833) | 1.0 (0.5–1.5) | 1.0 (0.5–1.5) | 1.0 (0.5–1.5) | 0.7 (0.5–1.0) |
| Supplementary oxygen (L/min), median (IQR) (805) | 3 (2–6) | 5 (4–6) | 2 (2–5) | 2 (0–4) |
| Outcomes | ||||
| In-hospital mortality, n (%)(821) | (9.2) | 48 (8.7) | 23 (12.7) | 6 (6.0) |
| Hospital length of stay (days), median (IQR) (833) | 6 (3–10) | 5 (3–10) | 7 (5–11) | 6 (6–11) |
The number inside the brackets indicates the number included in the analyses. If a vital sign was missing it was assumed to be normal.
*Malignancy –, without metastases; malignancy +, with metastases.
†From ED to IC/MCU; patients with a DNR status are not included in this calculation.
‡Percentage does not add up to 100% because some patients had multiple suspected sources of infection.
ASZ, Albert Schweitzer Hospital; COPD, chronic obstructive pulmonary disease; DNR, do not resuscitate order; ICU, intensive care unit; LUMC, Leiden University Medical Center; MCU, medium care unit; PIRO, Predisposition, Infection, Response and Organ failure; RH, Rijnstate Hospital.