Quang Hoang-Van, Nhung Le-Thi Kim, Thuy Pham-Thi Thanh, Loc Hoang-Van, Dung Ho Si
Department of Internal Medicine, Faculty of Medicine, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh Street, Ward 13, District 4, Ho Chi Minh City.Vietnam.
ICU Department, Thong Nhat Hospital, 1 Ly Thuong Kiet Street, Ward 7, District Tan Binh, Ho Chi Minh City. Vietnam.
Acta Inform Med. 2025;33(2):140-145. doi: 10.5455/aim.2025.33.140-145.
This study was to determine risk factors and prognostic models for mortality in elderly patients with Stenotrophomonas maltophilia bacteremia.
The aim of this study was to address this gap, we conducted this study to investigate the predictors of mortality and develop prognostic models for clinical practice.
A retrospective study was conducted on 195 patients ≥ 60 years of age (median age 78 (68-85) years, 59.5 % male) at Thong Nhat National Teaching Hospital in Vietnam between January 1st, 2017 and December 31st, 2022. Patients who were treated in the hospital with the first positive blood culture for Stenotrophomonas maltophilia bacteremia were chosen for enrolment in this study. This investigation evaluated demographic and clinical characteristics and prognostic models for mortality.
The mortality rate was 37.4 %. Multivariate analysis showed that the significant independent risk factors for mortality were age (aOR, 1.08; 95 % CI, 1.04-1.13; p < 0.001), SOFA score (aOR, 1.38; 95 % CI, 1.14-1.68; p < 0.001), and APACHE II score (aOR, 1.10, 95 % CI, 1.03-1.17; p = 0.005). Bayesian model averaging method identified four clinically applicable models: age combined with both SOFA score and APACHE II score (AUC 0.884, R2 0.564), age combined SOFA score (AUC 0.874, R2 0.516), age combined APACHE II score (AUC 0.800, R2 0.340), SOFA score combined APACHE II (AUC 0.846, R2 0.507).
Stenotrophomonas maltophilia bacteremia was severe in elderly patients with high mortality. Risk factors for mortality included age, SOFA, and APACHE II scores. The model comprising age, SOFA, and APACHE II scores has the best predictive ability. However, the model including age and SOFA score was also clinically valid and simple.
本研究旨在确定嗜麦芽窄食单胞菌血症老年患者的死亡危险因素和预后模型。
为填补这一空白，本研究旨在调查死亡的预测因素，并开发适用于临床实践的预后模型。
对越南通南国立教学医院2017年1月1日至2022年12月31日期间收治的195例年龄≥60岁（中位年龄78（68 - 85）岁，男性占59.5%）的患者进行回顾性研究。选取首次血培养嗜麦芽窄食单胞菌血症阳性且在该医院接受治疗的患者纳入本研究。本调查评估了人口统计学和临床特征以及死亡的预后模型。
死亡率为37.4%。多因素分析显示，死亡的显著独立危险因素为年龄（校正比值比，1.08；95%置信区间，1.04 - 1.13；p < 0.001）、序贯器官衰竭评估（SOFA）评分（校正比值比，1.38；95%置信区间，1.14 - 1.68；p < 0.001）和急性生理与慢性健康状况评分系统II（APACHE II）评分（校正比值比，1.10，95%置信区间，1.03 - 1.17；p = 0.005）。贝叶斯模型平均法确定了四个临床适用模型：年龄与SOFA评分和APACHE II评分相结合（曲线下面积（AUC）0.884，决定系数（R2）0.564）、年龄与SOFA评分相结合（AUC 0.874，R2 0.516）、年龄与APACHE II评分相结合（AUC 0.800，R2 0.340）、SOFA评分与APACHE II相结合（AUC 0.846，R2 0.507）。
嗜麦芽窄食单胞菌血症在老年患者中病情严重，死亡率高。死亡危险因素包括年龄、SOFA评分和APACHE II评分。包含年龄、SOFA评分和APACHE II评分的模型具有最佳预测能力。然而，包含年龄和SOFA评分的模型在临床上也有效且简单。
