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[MPB-INFURG-SEMES模型在急诊科预测实体瘤患者菌血症中的应用价值]

[Usefulness of the MPB-INFURG-SEMES model to predict bacteremia in the patient with solid tumor in the Emergency Department].

作者信息

Muelas González M, Torner Marchesi E, Peláez Díaz G, Ramos Aranguez M, Cabañas Morafraile J, López Forero W, Rubio Díaz R, González Del Castillo J, Candel F J, Julián-Jiménez A

机构信息

Dr. Agustín Julián-Jiménez, MD, PhD. Servicio de Urgencias-Coordinador de Docencia, Formación, Investigación y Calidad. Complejo Hospitalario Universitario de Toledo, Toledo, España. Avda. de Barber nº 30. C.P: 45.004. Toledo. Spain.

出版信息

Rev Esp Quimioter. 2024 Jun;37(3):257-265. doi: 10.37201/req/004.2024. Epub 2024 Mar 23.

Abstract

OBJECTIVE

To analyse a new risk score to predict bacteremia (MPB-INFURG-SEMES) in the patients with solid tumor attender for infection in the emergency departments (ED).

METHODS

Prospective, multicenter observational cohort study of blood cultures (BC) obtained from adult patients with solid neoplasia treated in 63 EDs for infection from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the chosen cut-off for getting the sensitivity, specificity, positive predictive value and negative predictive value.

RESULTS

A total of 857 blood samples wered cultured. True cases of bacteremia were confirmed in 196 (22.9%). The remaining 661 cultures (77.1%) wered negative. And, 42 (4.9%) were judged to be contaminated. The model's area under the receiver operating characteristic curve was 0.923 (95% CI,0.896-0.950). The prognostic performance with a model's cut-off value of ≥ 5 points achieved 95.74% (95% CI, 94,92-96.56) sensitivity, 76.06% (95% CI, 75.24-76.88) specificity, 53.42%(95% CI, 52.60-54.24) positive predictive value and 98.48% (95% CI, 97.66- 99.30) negative predictive value.

CONCLUSIONS

The MPB-INFURG-SEMES score is useful for predicting bacteremia in the adults patients with solid tumor seen in the ED.

摘要

目的

分析一种新的风险评分,以预测急诊科(ED)中因感染就诊的实体瘤患者发生菌血症(MPB-INFURG-SEMES)的情况。

方法

对2019年11月1日至2020年3月31日期间在63个急诊科接受感染治疗的成年实体瘤患者进行前瞻性、多中心观察性队列研究,采集血培养(BC)样本。采用受试者操作特征曲线下面积(AUC-ROC)分析该模型的预测能力。通过选定的截断值计算菌血症确诊病例的预后性能,以得出敏感性、特异性、阳性预测值和阴性预测值。

结果

共培养了857份血样。确诊菌血症的实际病例有196例(22.9%)。其余661份培养物(77.1%)为阴性。另外,42份(4.9%)被判定为污染。该模型的受试者操作特征曲线下面积为0.923(95%CI,0.896 - 0.950)。模型截断值≥5分时的预后性能达到敏感性95.74%(95%CI,94.92 - 96.56)、特异性76.06%(95%CI,75.24 - 76.88)、阳性预测值53.42%(95%CI,52.60 - 54.24)和阴性预测值98.48%(95%CI,97.66 - 99.30)。

结论

MPB-INFURG-SEMES评分有助于预测急诊科中成年实体瘤患者发生菌血症的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8af6/11094639/54181a967ada/revespquimioter-37-257-g001.jpg

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