OBJECTIVE: The objective of this study was to validate a previously published clinical decision rule for predicting a positive blood culture in emergency department (ED) patients with suspected infection on the basis of major and minor criteria and a total score (Shapiro et al., J Emerg Med, 2008; 35:255-264). METHODS: This is a retrospective matched cohort study of adult ED patients with blood cultures obtained from 1 January 2011 through to 31 December 2011. ED patients with blood culture-confirmed bacteremia were matched 1 : 3 with patients with negative cultures. The outcome was 'true bacteremia'. Data on clinical history, comorbid illnesses, physical observations, and laboratory tests were used to evaluate the application of the clinical decision rule. We report the sensitivity, specificity, and area under the curve. RESULTS: Among 1526 patients, 105 (6.9%) patients were classified with true bacteremia. The sensitivity of the prediction rule was 94% (95% confidence interval, 88-98%) and the specificity was 48% (95% confidence interval, 42-53%). The area under the receiver-operating characteristics curve was 0.83. CONCLUSION: The clinical decision rule performed well in our ED setting and is likely to be a useful supplement to clinical judgment.
OBJECTIVE: The objective of this study was to validate a previously published clinical decision rule for predicting a positive blood culture in emergency department (ED) patients with suspected infection on the basis of major and minor criteria and a total score (Shapiro et al., J Emerg Med, 2008; 35:255-264). METHODS: This is a retrospective matched cohort study of adult ED patients with blood cultures obtained from 1 January 2011 through to 31 December 2011. ED patients with blood culture-confirmed bacteremia were matched 1 : 3 with patients with negative cultures. The outcome was 'true bacteremia'. Data on clinical history, comorbid illnesses, physical observations, and laboratory tests were used to evaluate the application of the clinical decision rule. We report the sensitivity, specificity, and area under the curve. RESULTS: Among 1526 patients, 105 (6.9%) patients were classified with true bacteremia. The sensitivity of the prediction rule was 94% (95% confidence interval, 88-98%) and the specificity was 48% (95% confidence interval, 42-53%). The area under the receiver-operating characteristics curve was 0.83. CONCLUSION: The clinical decision rule performed well in our ED setting and is likely to be a useful supplement to clinical judgment.
Authors: Agustín Julián-Jiménez; Juan González Del Castillo; Eric Jorge García-Lamberechts; Itziar Huarte Sanz; Carmen Navarro Bustos; Rafael Rubio Díaz; Josep María Guardiola Tey; Ferrán Llopis-Roca; Pascual Piñera Salmerón; Mikel de Martín-Ortiz de Zarate; Jesús Álvarez-Manzanares; Julio Javier Gamazo-Del Rio; Marta Álvarez Alonso; Begoña Mora Ordoñez; Oscar Álvarez López; María Del Mar Ortega Romero; María Del Mar Sousa Reviriego; Ramón Perales Pardo; Henrique Villena García Del Real; María José Marchena González; José María Ferreras Amez; Félix González Martínez; Francisco Javier Martín-Sánchez; Pedro Beneyto Martín; Francisco Javier Candel González; Antonio Jesús Díaz-Honrubia Journal: Infection Date: 2021-09-06 Impact factor: 3.553
Authors: S Z Iqbal-Mirza; R Estévez-González; V Serrano-Romero de Ávila; E de Rafael González; E Heredero-Gálvez; A Julián-Jiménez Journal: Rev Esp Quimioter Date: 2019-11-29 Impact factor: 1.553
Authors: Svenja Laukemann; Nina Kasper; Prasad Kulkarni; Deborah Steiner; Anna Christina Rast; Alexander Kutz; Susan Felder; Sebastian Haubitz; Lukas Faessler; Andreas Huber; Christoph A Fux; Beat Mueller; Philipp Schuetz Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817