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Meta-analysis of studies of combination vs monotherapy of life-threatening infections associated with sepsis and septic shock. .001. .01. .1. .2. .5. 1. 2. 5. 10. 100. odds ratio (95% confidence interval). Kumar et al, Crit Care Med 2010:38:1651-1664.
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Meta-analysis of studies of combination vs monotherapy of life-threatening infections associated with sepsis and septic shock .001 .01 .1 .2 .5 1 2 5 10 100 odds ratio (95% confidence interval) Kumar et al, Crit Care Med 2010:38:1651-1664
Meta-analysis of studies of combination vs monotherapy of life-threatening infections associated with sepsis and septic shock Kumar et al, Crit Care Med 2010:38:1651-1664 .001 .01 .1 .2 .5 1 2 5 10 100 odds ratio (95% confidence interval)
Monotherapy mortality 15-25% Monotherapy mortality >25% Monotherapy mortality <15% Odds ratio meta-analysis plot [random effects] Vazquezb Carbon Sculier Chamota,c McCue Karnad Kljucar D'Antonio Kuikka Vazqueza Hilfa Harbarthb,c Watanakunkorn Dwyera Klatersky Gullberg Montgomerie Baddoura,c Siegman-Igra Graninger Rodrigueza Baddourb,c Leibovici Ko Chowa Heylanda,c Aspa Fainstein Kim Waterer Maki Chokshi Dupont Dwyerb Mendelson Patterson Martinez Garnacho-Monterob Kim Chowb Damas Heylandb,c Harbartha,c Korvicka Korvickb Fernandez-Guerrero Bodey2 Cometta Rodriguezb Kuikka Feldman Kreger Bodey1b Piccart McCue Chamotb,c Bodey1a Hilfb Bouza Tapper Garnacho-Monteroa Hammond combined combined combined .001 .01 .1 .2 .5 1 2 5 10 100 .001 .01 .1 .2 .5 1 2 5 10 100 1000 .01 .1 .2 .5 1 2 5 10 100 odds ratio (95% confidence interval) Favors combination Favors monotherapy Kumar et al, Crit Care Med 2010:38:1651-1664
Metaregression: All studies OR 1.304 (1.205-1.412) per 10% mortality increment, p<.0001 Kumar et al, Crit Care Med 2010:38:1651-1664
Metaregression: Non-RCTs OR 1.475 (1.385-1.569) per 10% mortality increment, p<.0001 Kumar et al, Crit Care Med 2010:38:1651-1664
Metaregression: RCTs OR 1.425 (1.121-1.811) per 10% mortality increment, p=.0159 Kumar et al, Crit Care Med 2010:38:1651-1664
Meta-analysis (shock/critically ill stratified): Combination vs Monotherapy 2 Group Odds Ratio I (%) P-value non-shock 1.11 (0.77-1.58) 11.1 .5786 shock 0.54 (0.36-0.80) 0 .0020 non-critically ill 1.10 (0.46-2.60) 45.3 .8321 critically ill 0.33 (0.15-0.74) 0 .0067 non-shock/non-critically ill 1.10 (0.80-1.53) 17.7 .5566 shock/critically ill 0.49 (0.35-0.70) 0 <.0001 overall 0.76 (0.57-1.02) 34.3 .0654 0.1 1 10 Kumar et al, Crit Care Med 2010:38:1651-1664 Combo Therapy Favored Monotherapy Favored Odds Ratio of Death