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Table 3 Summary of survey results and frequencies for microbiology testing and antimicrobial use for all GTSQs by working diagnosis (Item 3)

From: Ground truth labels challenge the validity of sepsis consensus definitions in critical illness

Item (number) or characteristic

Affirmative/non-affirmative responsesa

Affirmative responsesb

All edited GTSQs (n = 7291)

Neither SIRS nor sepsis (n = 2206)

SIRS (n = 1056)

Sepsis (n = 732)

Severe sepsis (n = 1167)

Septic shock (n = 2012)

Encounters contributing n GTSQs

798

523

266

183

174

264

GTSQs per contributing encounter

 Median (interquartile range)

5 (2–12)

2 (1–6)

3 (2–5)

3 (2–5)

4 (2–9)

5 (2–10)

Suspected infection (4)

376/6232 (90.6)

70 (3.2)

87 (8.2)

56 (7.7)

48 (4.1)

115 (5.7)

Focus localization (5)

4184/2982 (98.3)

233 (10.6)

232 (22.0)

646 (88.3)

1124 (96.3)

1949 (96.9)

 Localization unclear

153 (2.1)

45 (2.0)

30 (2.8)

18 (2.5)

9 (0.8)

51 (2.5)

 Abdominal, suspected

387 (5.3)

9 (0.4)

21 (2.0)

33 (4.5)

91 (7.8)

233 (11.6)

 Abdominal, confirmed

1390 (19.1)

23 (1.0)

38 (3.6)

150 (20.5)

454 (38.9)

725 (36.0)

 Thoracic, suspected

834 (11.4)

23 (1.0)

48 (4.6)

124 (16.9)

199 (17.1)

440 (21.9)

 Thoracic, confirmed

1381 (18.9)

68 (3.1)

69 (6.5)

158 (21.6)

432 (37.0)

654 (32.5)

 Urogenital, suspected

49 (0.7)

2 (0.1)

4 (0.4)

5 (0.7)

16 (1.4)

22 (1.1)

 Urogenital, confirmed

110 (1.5)

2 (0.1)

1 (0.1)

22 (3.0)

35 (3.0)

50 (2.5)

 Intracranial/meningeal, suspected

35 (0.5)

2 (0.1)

5 (0.5)

8 (1.1)

3 (0.3)

17 (0.8)

 Intracranial/meningeal, confirmed

239 (3.3)

34 (1.5)

5 (0.5)

58 (7.9)

68 (5.8)

74 (3.7)

 Bone/joint, suspected

65 (0.9)

9 (0.4)

4 (0.4)

7 (1.0)

22 (1.9)

23 (1.1)

 Bone/joint, confirmed

336 (4.6)

22 (1.0)

13 (1.2)

59 (8.0)

52 (4.5)

190 (9.4)

 Skin, suspected

106 (1.5)

2 (0.1)

1 (0.1)

26 (3.6)

44 (3.8)

33 (1.6)

 Skin, confirmed

188 (2.6)

8 (0.4)

2 (0.2)

38 (5.2)

29 (2.5)

111 (5.5)

 Blood stream, suspected

30 (0.4)

1 (0.1)

4 (0.6)

5 (0.4)

20 (1.0)

 Blood stream, confirmed

243 (3.3)

11 (0.5)

7 (0.7)

61 (8.3)

62 (5.3)

102 (5.1)

 Catheter, suspected

27 (0.4)

1 (0.1)

8 (1.1)

1 (0.1)

17 (0.8)

 Catheter, confirmed

10 (0.1)

1 (0.1)

4 (0.6)

5 (0.3)

 Endocarditisc, suspected

6 (0.1)

1 (0.1)

1 (0.1)

1 (0.1)

3 (0.3)

 Endocarditis, confirmed

6 (0.1)

3 (0.4)

3 (0.2)

 More than 1 focus of infection

1242 (17.0)

23 (1.0)

17 (1.6)

128 (17.5)

352 (30.2)

722 (35.9)

Source control (6)

432/6,647 (97.1)

22 (1.0)

10 (1.0)

61 (8.3)

52 (4.5)

284 (14.1)

 Surgical

354 (4.9)

18 (0.8)

6 (0.6)

41 (5.6)

39 (3.3)

247 (12.3)

 Interventional

43 (0.6)

2 (0.2)

7 (1.0)

11 (0.9)

23 (1.1)

 Catheter change

35 (0.5)

4 (0.2)

11 (1.5)

2 (0.2)

18 (0.9)

 Other

15 (0.2)

2 (0.2)

4 (1.6)

1 (0.1)

8 (0.4)

Acute organ dysfunction (9)d

5267/1649 (94.9)

963 (43.7)

756 (71.6)

524 (71.6)

1086 (93.1)

1938 (96,3)

 Gastrointestinal

831 (11.4)

41 (1.86)

8 (6.44)

69 (9.43)

176 (15.1)

477 (23.7)

 Lung

3961 (54.3)

348 (15.8)

511 (48.4)

372 (50.8)

948 (81.2)

1782 (88.6)

 Kidney

2266 (31.1)

130 (5.89)

236 (22.3)

109 (14.9)

567 (48.6)

1224 (60.8)

 Brain

1796 (24.6)

628 (28.5)

292 (27.7)

160 (21.9)

204 (17.5)

512 (25.4)

 Heart

1061 (14.6)

58 (2.63)

125 (11.8)

57 (7.79)

118 (10.1)

703 (34.9)

 Coagulation system

730 (10.0)

29 (1.31)

51 (4.83)

38 (5.19)

124 (10.6)

488 (24.3)

 Bone marrow

973 (13.3)

34 (1.54)

93 (8.81)

47 (6.42)

203 (17.4)

596 (29.6)

 Liver

805 (11.0)

13 (0.59)

71 (6.72)

15 (2.05)

168 (14.4)

538 (26.7)

Macrocirculatory abnormalities (7)

3060/4008 (96.9)

256 (11.6)

402 (38.1)

162 (22.1)

332 (28.4)

1907 (94.8)

 Volume replacement therapy

1229 (16.9)

56 (2.5)

107 (10.1)

46 (6.3)

153 (13.1)

866 (43.0)

 Capillary leak

634 (8.7)

9 (0.4)

29 (2.8)

6 (0.8)

36 (3.1)

554 (27.5)

 Catecholamine requirement

2887 (39.6)

244 (11.1)

388 (36.7)

138 (18.9)

230 (19.7)

1886 (93.7)

Microcirculatory dysfunction (8)

1435/5646 (97.1)

55 (2.5)

106 (10.0)

51 (7.0)

190 (16.3)

1033 (51.3)

 Clinical suspicion

675 (9.3)

12 (0.5)

30 (2.8)

11 (1.5)

82 (7.0)

540 (26.8)

 Recapillarization time > 2 s

122 (1.7)

6 (0.3)

5 (0.5)

2 (0.2)

109 (5.4)

 Hyperlactatemia (> 2 mmol/L)

1009 (13.8)

46 (2.1)

76 (7.2)

35 (4.8)

110 (9.4)

742 (36.9)

 (ScvO2) > 80%

395 (5.4)

19 (0.9)

25 (2.4)

6 (0.8)

55 (4.7)

290 (14.4)

Preceding 24-h trend (2)

 Improved

1440 (19.8)

491 (22.3)

241 (22.8)

170 (23.2)

248 (21.3)

290 (14.4)

 Deteriorated

1,062 (14.6)

137 (6.21)

158 (15.0)

86 (11.7)

131 (11.2)

547 (27.2)

 Unchanged

4665 (64.0)

1574 (71.4)

655 (62.0)

474 (64.8)

788 (67.5)

1174 (58.3)

Expected 24-h trend (10)

 Improve

1050 (14.4)

376 (17.0)

161 (15.2)

130 (17.8)

153 (13.1)

230 (11.4)

 Deteriorate

493 (6.7)

60 (2.7)

74 (7.0)

30 (4.1)

38 (3.3)

291 (14.5)

 No change

5542 (76.0)

1754 (79.5)

807 (76.4)

565 (77.2)

957 (82.0)

1459 (72.5)

Among (1)

 3 most severely ill ICU patients

1030 (14.1)

95 (4.3)

112 (10.6)

21 (2.9)

128 (11.0)

670 (33.3)

 3 least severely ill ICU patients

1029 (14.1)

649 (29.4)

132 (12.5)

125 (17.1)

58 (5.0)

58 (2.9)

Microbiology testing

 Blood cultures

1713 (23.5)

404 (18.3)

285 (27.0)

152 (20.8)

246 (21.1)

607 (30.2)

 Bronchial lavage

556 (7.63)

65 (2.95)

74 (7.01)

44 (6.01)

104 (8.91)

262 (13.0)

 Antimicrobial therapy

3775 (51.8)

274 (12.4)

238 (22.5)

519 (70.9)

894 (76.6)

1789 (88.9)

  1. ScvO2 central venous oxygen saturation
  2. aAbsolute numbers for explicitly affirmative and non-affirmative responses to GTSQ items are separated by a slash, and the percentage of the column category (n) for their sum is given in parentheses. Else, numbers for affirmative replies or counts (% of column category) are given
  3. bThe working diagnosis (Item 3) was not assigned in 118 (1.62%) of all 7291 edited questionnaires
  4. c“Endocarditis” was included into Item 5 only from 01/08/2016 onwards in altogether 7025 GTSQs
  5. dNot chronic preexisting