[Predictive factors of bacteraemia in the patients seen in emergency departments due to infections].

OBJECTIVE

The aim of the study was to analyze predictive factors of bacteraemia in patients seen in the emergency department (ED) for an episode of infectious disease.

METHODS

Observational, retrospective and descriptive analytical study of all blood cultures extracted in an ED in adult patients (≥ 18 years) seen in ED due to infec-tious disease from 1-1-2019 to 1-7-2019. The follow-up was carried out during 30 days. Thirty-eight variables for predicting bacteraemia were assessed. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Univariate and multivariate logistic regression analysis was performed.

RESULTS

A total of 1,425 blood cultures were finally enrolled in the study. Of those were considered true bacteremia 179 (12.6 %) and as negative blood cultures 1,246 (87.4 %). Amongst negatives, 1,130 (79.3%) without growth and 116 (8.1%) as contaminants blood cultures. Five variables were significantly associated with true bacteraemia: serum procalcitonin (PCT) ≥ 0.51 ng/ml [odds ratio (OR): 4.52; 95% confidence interval (CI): 4.20-4.84, P <.001], temperature > 38.3°C [OR:1.60; 95% CI:1.29-1.90, P <.001], systolic blood pressure (SBP) < 100 mmHg [OR:3.68; 95% CI:2.78-4.58, P <.001], septic shock [OR:2.96; 95% CI:1.78-4.13, P <.001] and malignancy [OR:1.73; 95% CI:1.27-2.20, P <.001].

CONCLUSIONS

Several factors evaluated in an initial assessment in the ED, including serum PCT, temperature, hypotension (with/without septic shock) and being malignancy, were found to predict true bacteraemia.