Development and validation of a risk score for predicting positivity of blood cultures and mortality in patients with bacteremia and fungemia

dc.contributor.authorTuon F.F.
dc.contributor.authorTelles J.P.
dc.contributor.authorCieslinski J.
dc.contributor.authorBorghi M.B.
dc.contributor.authorBertoldo R.Z.
dc.contributor.authorRibeiro V.S.T.
dc.date.accessioned2024-03-12T19:18:29Z
dc.date.available2024-03-12T19:18:29Z
dc.date.issued2021
dc.description.abstract© 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.
dc.description.firstpage1865
dc.description.issuenumber4
dc.description.lastpage1871
dc.description.volume52
dc.identifier.doi10.1007/s42770-021-00581-5
dc.identifier.issn1678-4405
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/34553
dc.relation.ispartofBrazilian Journal of Microbiology
dc.rightsAcesso Restrito
dc.subject.otherlanguageBacteremia
dc.subject.otherlanguageBlood culture
dc.subject.otherlanguageMortality prediction
dc.subject.otherlanguagePitt score
dc.subject.otherlanguageStaphylococcus
dc.titleDevelopment and validation of a risk score for predicting positivity of blood cultures and mortality in patients with bacteremia and fungemia
dc.typeArtigo
local.scopus.citations2
local.scopus.eid2-s2.0-85111089822
local.scopus.subjectAdult
local.scopus.subjectAged
local.scopus.subjectBacteremia
local.scopus.subjectBlood Culture
local.scopus.subjectBrazil
local.scopus.subjectCohort Studies
local.scopus.subjectFungemia
local.scopus.subjectHumans
local.scopus.subjectMicrobiological Techniques
local.scopus.subjectMiddle Aged
local.scopus.subjectModels, Statistical
local.scopus.subjectPredictive Value of Tests
local.scopus.subjectProspective Studies
local.scopus.subjectReproducibility of Results
local.scopus.subjectRetrospective Studies
local.scopus.subjectRisk Factors
local.scopus.subjectROC Curve
local.scopus.updated2024-06-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85111089822&origin=inward
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