University of South Carolina School of Medicine, Columbia, SC, United States of America; Department of Medicine, Division of Infectious Diseases, Prisma Health-Midlands, Columbia, SC, United States of America.
University of South Carolina College of Pharmacy, Columbia, SC, United States of America.
J Infect. 2022 Feb;84(2):131-135. doi: 10.1016/j.jinf.2021.12.002. Epub 2021 Dec 9.
The quick Pitt bacteremia score (qPitt) predicts mortality in patients with serious infections due to gram-negative bacteria. This retrospective cohort study examines utility of qPitt to predict mortality in patients with Staphylococcus aureus bloodstream infection (SAB).
Multivariate logistic regression was used to examine risk factors for 28-day mortality in hospitalized adults with SAB at four Prisma Health hospitals in South Carolina, USA from January 2015 to December 2017. Area under receiver operating characteristic curve (AUROC) was used to examine model discrimination.
Among 692 patients with SAB, 305 (44%) had methicillin-resistant S. aureus (MRSA), and 129 (19%) died within 28 days. After adjustment for age, comorbidities, and MRSA, each component of the qPitt was associated with 28-day mortality. There was a 3-fold increase in the risk of 28-day mortality for each one-point increase in qPitt. Predicted 28-day mortality was 3%, 9%, 22%, 45%, and 70% for qPitt of 0, 1, 2, 3, and ≥4, respectively. AUROC of the qPitt in predicting 28-day, 14-day, and in-hospital mortality were 0.80, 0.81, and 0.80, respectively.
The qPitt predicts mortality with good discrimination in SAB. These results support using qPitt as a measure of acute severity of illness in future studies.
快速 Pitt 菌血症评分（qPitt）可预测革兰氏阴性菌引起的严重感染患者的死亡率。本回顾性队列研究旨在探讨 qPitt 在预测金黄色葡萄球菌血流感染（SAB）患者死亡率中的作用。
采用多变量逻辑回归分析 2015 年 1 月至 2017 年 12 月美国南卡罗来纳州 4 家 Prisma Health 医院住院成人 SAB 患者 28 天死亡率的危险因素。采用受试者工作特征曲线下面积（AUROC）评估模型的判别能力。
在 692 例 SAB 患者中，305 例（44%）为耐甲氧西林金黄色葡萄球菌（MRSA），129 例（19%）在 28 天内死亡。在调整年龄、合并症和 MRSA 后，qPitt 的每个组成部分均与 28 天死亡率相关。qPitt 每增加 1 分，28 天死亡率的风险增加 3 倍。qPitt 评分为 0、1、2、3 和≥4 时，预测 28 天死亡率分别为 3%、9%、22%、45%和 70%。qPitt 预测 28 天、14 天和住院死亡率的 AUROC 分别为 0.80、0.81 和 0.80。
qPitt 可较好地区分 SAB 患者的死亡率。这些结果支持在未来的研究中使用 qPitt 作为评估急性疾病严重程度的指标。
