Department of Laboratory Science and Infectious Diseases, A. Gemelli University Polyclinic Foundation IRCCS, Rome, Italy; Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Catholic University of the Sacred Heart, Rome, Italy.
Am J Infect Control. 2024 Dec;52(12):1377-1383. doi: 10.1016/j.ajic.2024.07.011. Epub 2024 Jul 26.
A bloodstream infection (BSI) prognostic score applicable at the time of blood culture collection is missing.
In total, 4,327 patients with BSIs were included, divided into a derivation (80%) and a validation dataset (20%). Forty-two variables among host-related, demographic, epidemiological, clinical, and laboratory extracted from the electronic health records were analyzed. Logistic regression was chosen for predictive scoring.
The 14-day mortality model included age, body temperature, blood urea nitrogen, respiratory insufficiency, platelet count, high-sensitive C-reactive protein, and consciousness status: a score of ≥ 6 was correlated to a 14-day mortality rate of 15% with a sensitivity of 0.742, a specificity of 0.727, and an area under the curve of 0.783. The 30-day mortality model further included cardiovascular diseases: a score of ≥ 6 predicting 30-day mortality rate of 15% with a sensitivity of 0.691, a specificity of 0.699, and an area under the curve of 0.697.
A quick mortality score could represent a valid support for prognosis assessment and resources prioritizing for patients with BSIs not admitted in the intensive care unit.
目前缺乏一种适用于采集血培养时的血流感染（BSI）预后评分。
共纳入 4327 例 BSI 患者，分为推导数据集（80%）和验证数据集（20%）。从电子病历中提取了 42 个与宿主相关、人口统计学、流行病学、临床和实验室相关的变量进行分析。选择逻辑回归进行预测评分。
14 天死亡率模型包括年龄、体温、血尿素氮、呼吸功能不全、血小板计数、高敏 C 反应蛋白和意识状态：评分≥6 与 14 天死亡率为 15%相关，敏感性为 0.742，特异性为 0.727，曲线下面积为 0.783。30 天死亡率模型进一步包括心血管疾病：评分≥6 预测 30 天死亡率为 15%，敏感性为 0.691，特异性为 0.699，曲线下面积为 0.697。
对于未入住重症监护病房的 BSI 患者，快速死亡率评分可以作为预后评估和资源分配的有效支持。
