1. Optimizing Outcomes in Sepsis Dr. Anand Kumar
Cumulative Initiation of Effective Antimicrobial Therapy and Survival in Septic Shock
1.0
survival fraction
cumulative antibiotic
initiation
0.8
0.6
fraction of total patients
0.4
0.2
0.0
0-0.5
0.5-1
9-12
12-24
24-36
1-2
2-3
3-4
4-5
5-6
6-9
36+
time from hypotension onset (hrs)
Kumar et al. CCM. 2006:34:
New Insights into Infection Issues in the Canadian ICU Setting - Satellite Symposium Thursday, March 15th, 2007

2. Optimizing Outcomes in Sepsis Dr. Anand Kumar
Funk and Kumar, Critical Care Clinics 2011 (in press)
New Insights into Infection Issues in the Canadian ICU Setting - Satellite Symposium Thursday, March 15th, 2007

3. Optimizing Outcomes in Sepsis Dr. Anand Kumar
Mortality Risk with Increasing Delays in Initiation of Effective Antimicrobial Therapy
Time (hrs)
1-1.99
2-2.99
3-3.99
4-4.99
5-5.99
6-8.99
> 36
Odds Ratio of Death
(95% Confidence Interval) 1 10
100
Kumar et al, CCM. 2006:34:
New Insights into Infection Issues in the Canadian ICU Setting - Satellite Symposium Thursday, March 15th, 2007

4. Risk of Death with Increasing Antimicrobial Delays: Subgroups
Optimizing Outcomes in Sepsis Dr. Anand Kumar
Risk of Death with Increasing Antimicrobial Delays: Subgroups N
all
2154
documented
1695
suspected
459
culture +
1546
culture -
608
bacteremia +
769
bacteremia -
1385
community
1242
nosocomial
912
gram +
584
gram -
768
fungal
131
Survival = 0.79/1.119x x = delay (hrs)
respiratory
838
urinary tract
230
intra-abdominal
641
skin/soft tissue
156
1.0
1.1
1.2
1.3
Kumar et al, CCM. 2006:34:
Adjusted Odds Ratio of Death
New Insights into Infection Issues in the Canadian ICU Setting - Satellite Symposium Thursday, March 15th, 2007