Development and validation of a risk score for predicting positivity of blood cultures and mortality in patients with bacteremia and fungemia
Tipo
Artigo
Data de publicação
2021
Periódico
Brazilian Journal of Microbiology
Citações (Scopus)
2
Autores
Tuon F.F.
Telles J.P.
Cieslinski J.
Borghi M.B.
Bertoldo R.Z.
Ribeiro V.S.T.
Telles J.P.
Cieslinski J.
Borghi M.B.
Bertoldo R.Z.
Ribeiro V.S.T.
Orientador
Título da Revista
ISSN da Revista
Título de Volume
Membros da banca
Programa
Resumo
© 2021, Sociedade Brasileira de Microbiologia.Introduction: Bacteremia is a major cause of morbidity and mortality in hospitalized patients. Predictors of mortality are critical for the management and survival of hospitalized patients. The objective of this study was to determine the factors related to blood culture positivity and the risk factors for mortality in patients whose blood cultures were collected. Methods: A prospective 2-cohort study (derivation with 784 patients and validation with 380 patients) based on the Pitt bacteremia score for all patients undergoing blood culture collection. The score was obtained from multivariate analysis. The Kaplan–Meier survival curve of the cohort derivation and the cohort validation groups was calculated, and the difference was assessed using a log-rank test. Mortality-related factors were older age, extended hospitalization, > 10% of immature cells in the leukogram, lower mean blood pressure, elevated heart rate, elevated WBC count, and elevated respiratory rate. These continuous variables were dichotomized according to their significance level, and a cut-off limit was created. Results: The area under the ROC curve (AUC) was 0.789. The score was validated in a group of 380 patients who were prospectively evaluated. Conclusion: Prolonged hospitalization, body temperature, and elevated heart rate were related to positive blood cultures. The Pitt score can be used to assess the risk of death; however it can be individualized according to the epidemiology of each hospital.
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Assuntos Scopus
Adult , Aged , Bacteremia , Blood Culture , Brazil , Cohort Studies , Fungemia , Humans , Microbiological Techniques , Middle Aged , Models, Statistical , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Retrospective Studies , Risk Factors , ROC Curve