Daiki Kobayashi1, Kyoko Yokota2, Osamu Takahashi3, Hiroko Arioka4, Tsuguya Fukui5. 1. Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan; Center for Clinical Epidemiology, St. Luke's Life Science Institute, Japan; Department of Infectious Disease, Faculty of Medicine, Kagawa University, Kagawa, Japan. Electronic address: daikoba@luke.ac.jp. 2. Department of Infectious Disease, Faculty of Medicine, Kagawa University, Kita-gun, Japan. Electronic address: kyoyokota@hotmail.com. 3. Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan; Center for Clinical Epidemiology, St. Luke's Life Science Institute, Japan. Electronic address: otakahas@luke.ac.jp. 4. Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan. Electronic address: arihiro@luke.ac.jp. 5. Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan. Electronic address: fkts@luke.ac.jp.
Abstract
OBJECTIVE: To create a predictive rule to identify risk factors for mortality among patients with Staphylococcus aureus bacteraemia (SAB). DESIGN, SETTING AND PATIENTS: This was a retrospective cohort study of all adult patients with SAB at a large community hospital in Tokyo, Japan, from April 1, 2004 to March 31, 2011. Baseline data and clinically relevant factors were collected from electronic charts. The primary outcome was in-hospital mortality. All candidate predictors were included in a classification and regression tree (CART) analysis. A receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was obtained. A cross-validation analysis was performed. MEASUREMENTS AND MAIN RESULTS: A total of 340 patients had SAB during the study period. Of these, 118 (34.7%) patients died in hospital. Among 41 potential variables, the CART analysis revealed that underlying malignancy, serum blood glucose level, methicillin resistance, and low serum albumin were predictors of mortality. The AUC was 0.73 (95% CI: 0.67-0.79). For validation, the estimated risk was 0.26 (± SE: 0.02) in the resubstitution analysis and 0.33 (± SE: 0.03) in the cross-validation analysis. CONCLUSION: We propose a predictive model for the mortality of patients with SAB consisting of four predictors: underlying malignancy, low serum albumin, high glucose, and methicillin resistance. This model may facilitate appropriate preventative management for patients with SAB who are at high risk of mortality.
OBJECTIVE: To create a predictive rule to identify risk factors for mortality among patients with Staphylococcus aureus bacteraemia (SAB). DESIGN, SETTING AND PATIENTS: This was a retrospective cohort study of all adult patients with SAB at a large community hospital in Tokyo, Japan, from April 1, 2004 to March 31, 2011. Baseline data and clinically relevant factors were collected from electronic charts. The primary outcome was in-hospital mortality. All candidate predictors were included in a classification and regression tree (CART) analysis. A receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was obtained. A cross-validation analysis was performed. MEASUREMENTS AND MAIN RESULTS: A total of 340 patients had SAB during the study period. Of these, 118 (34.7%) patients died in hospital. Among 41 potential variables, the CART analysis revealed that underlying malignancy, serum blood glucose level, methicillin resistance, and low serum albumin were predictors of mortality. The AUC was 0.73 (95% CI: 0.67-0.79). For validation, the estimated risk was 0.26 (± SE: 0.02) in the resubstitution analysis and 0.33 (± SE: 0.03) in the cross-validation analysis. CONCLUSION: We propose a predictive model for the mortality of patients with SAB consisting of four predictors: underlying malignancy, low serum albumin, high glucose, and methicillin resistance. This model may facilitate appropriate preventative management for patients with SAB who are at high risk of mortality.
Authors: D Yahav; S Yassin; H Shaked; E Goldberg; J Bishara; M Paul; L Leibovici Journal: Eur J Clin Microbiol Infect Dis Date: 2016-02-12 Impact factor: 3.267
Authors: S Chatzipanagiotou; A Ioannidis; E Trikka-Graphakos; N Charalampaki; C Sereti; R Piccinini; A M Higgins; T Buranda; R Durvasula; A L Hoogesteijn; G P Tegos; Ariel L Rivas Journal: Front Immunol Date: 2016-06-10 Impact factor: 7.561