OBJECTIVES: To develop a simple risk score to predict bacteremia in patients in our hospital emergency department for infection. MATERIAL AND METHODS: Retrospective observational cohort study of all blood cultures ordered in the emergency department for adults (aged 18 or older) from July 1, 2018, to March 31, 2019. We gathered data on 38 independent variables (demographic, comorbidity, functional status, and laboratory findings) that might predict bacteremia. Univariate and multiple logistic regression analyses were applied to the data and a risk scale was developed. RESULTS: A total of 2181 blood samples were cultured. True cases of bacteremia were confirmed in 262 (12%). The remaining 1919 cultures (88%) were negative. No growth was observed in 1755 (80.5%) of the negative cultures, and 164 (7.5%) were judged to be contaminated. The 5MPB-Toledo model identified 5 predictors of bacteremia: temperature higher than 38.3°C (1 point), a Charlson comorbidity index of 3 or more (1 point), respiratory frequency of at least 22 breaths/min (1 point), leukocyte count greater than 12 000/mm3 (1 point), and procalcitonin concentration of 0.51 ng/mL or higher (4 points). Low risk for bacteremia was indicated by a score of 0 to 2 points, intermediate risk by 3 to 5 points, and high risk by 6 to 8 points. Bacteremia in these 3 risk groups was predicted for 1.1%, 10.5%, and 77%, respectively. The model's area under the receiver operating characteristic curve was 0.946 (95% CI, 0.922-0.969). CONCLUSION: The 5MPB-Toledo score could be useful for predicting bacteremia in patients attended in hospital emergency departments for infection.
OBJECTIVES: To develop a simple risk score to predict bacteremia in patients in our hospital emergency department for infection. MATERIAL AND METHODS: Retrospective observational cohort study of all blood cultures ordered in the emergency department for adults (aged 18 or older) from July 1, 2018, to March 31, 2019. We gathered data on 38 independent variables (demographic, comorbidity, functional status, and laboratory findings) that might predict bacteremia. Univariate and multiple logistic regression analyses were applied to the data and a risk scale was developed. RESULTS: A total of 2181 blood samples were cultured. True cases of bacteremia were confirmed in 262 (12%). The remaining 1919 cultures (88%) were negative. No growth was observed in 1755 (80.5%) of the negative cultures, and 164 (7.5%) were judged to be contaminated. The 5MPB-Toledo model identified 5 predictors of bacteremia: temperature higher than 38.3°C (1 point), a Charlson comorbidity index of 3 or more (1 point), respiratory frequency of at least 22 breaths/min (1 point), leukocyte count greater than 12 000/mm3 (1 point), and procalcitonin concentration of 0.51 ng/mL or higher (4 points). Low risk for bacteremia was indicated by a score of 0 to 2 points, intermediate risk by 3 to 5 points, and high risk by 6 to 8 points. Bacteremia in these 3 risk groups was predicted for 1.1%, 10.5%, and 77%, respectively. The model's area under the receiver operating characteristic curve was 0.946 (95% CI, 0.922-0.969). CONCLUSION: The 5MPB-Toledo score could be useful for predicting bacteremia in patients attended in hospital emergency departments for infection.
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: R Rubio Díaz; E de Rafael González; E Martín Torres; E Valera Núñez; A M López Martos; D Melguizo Melguizo; M P Picazo Perea; P J López García; P Fuentes Bullejos; M Chafer Rudilla; J F Carretero Gómez; A Julián-Jiménez Journal: Rev Esp Quimioter Date: 2021-12-03 Impact factor: 1.553