Acute organ dysfunction was defined as a new Sequential Organ Failure Assessment score [25] ≥3 in any of six organ systems, following the European Society of Intensive Care Medicine sepsis occurrence in the acutely ill patient study criteria [26] . We also added patients that met the following alternate definition to the analyses: an increase of 1 Sequential Organ Failure Assessment point in any two organ systems, 2 points in one system, or an absolute score of ≥3 in the respiratory system, similar to criteria used in several large trials of antisepsis agents [27] [28] [29] .