Department of Internal Medicine, University Hospital of Salamanca, Salamanca, Spain.
Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
Mycoses. 2017 Oct;60(10):676-685. doi: 10.1111/myc.12644. Epub 2017 Aug 21.
Candida bloodstream infection (CBI) is associated with high mortality. The aim of this study was to compare the utility of the combined use of the Pitt Bacteremia Score (PBS) and Charlson Comorbidity Index (CCI) or Chronic Disease Score (CDS) to predict mortality among patients with CBI. Thereby, all consecutive patients with CBI at our institution between 2010 and 2014 were included. The PBS was used to evaluate CBI severity and the CCI and CDS were used to assess comorbidities of patients with CBI. Logistic regression analysis was used to estimate odds ratios for 30-day mortality in models including the PBS and CCI or CDS. A total of 189 CBI episodes were identified. Logistic regression models including the PBS and either CCI or CDS showed that the combined use of a comorbidity score and a severity score significantly predicted 30-day mortality. The performance of the different models was similar. Aggregated scores of comorbidity (CCI and CDS) and disease severity (PBS) are useful for the prediction of 30-day mortality risk in patients with CBI. Their use may facilitate the analysis of risk factors for poorer outcome and the development of an index for CBI mortality.
念珠菌菌血症（CBI）与高死亡率相关。本研究旨在比较 Pitt 菌血症评分（PBS）与 Charlson 合并症指数（CCI）或慢性疾病评分（CDS）联合使用预测 CBI 患者死亡率的效用。因此，纳入了 2010 年至 2014 年期间我院所有连续发生的 CBI 患者。使用 PBS 评估 CBI 严重程度，CCI 和 CDS 评估 CBI 患者的合并症。使用逻辑回归分析估计包括 PBS 和 CCI 或 CDS 的模型中 30 天死亡率的比值比。共确定了 189 例 CBI 发作。包括 PBS 和 CCI 或 CDS 的逻辑回归模型表明，合并使用合并症评分和严重程度评分可显著预测 30 天死亡率。不同模型的性能相似。合并症（CCI 和 CDS）和疾病严重程度（PBS）的综合评分可用于预测 CBI 患者 30 天死亡率风险。它们的使用可能有助于分析预后不良的危险因素，并制定 CBI 死亡率指数。
