کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3377859 1220055 2014 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Derivation of a clinical prediction rule for bloodstream infection mortality of patients visiting the emergency department based on predisposition, infection, response, and organ dysfunction concept
ترجمه فارسی عنوان
تشخیص یک قانون پیش بینی بالینی برای مرگ و میر ناشی از عفونت خون در بیماران مراجعه کننده به بخش اورژانس براساس استعداد، عفونت، واکنش و مفهوم اختلال در بدن
کلمات کلیدی
باکتری، عفونت خون مرگ و میر مدل پیش بینی نمره باکتری های پیت
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی ایمونولوژی
چکیده انگلیسی

Background/PurposeBloodstream infection (BSI) is a serious infection with a high mortality. We aimed to construct a predictive scoring system to stratify the severity of patients with BSI visiting the emergency department (ED).MethodsWe conducted a retrospective cohort study consisting of patients who visited the ED of a tertiary hospital with documented BSI in 2010. The potential predictors of mortality were obtained via chart review. Multivariate logistic regression was utilized to identify predictors of mortality. Penalized maximum likelihood estimation (PMLE) was applied for score development.ResultsThere were 1063 patients with bacteremia included, with an overall 28-day mortality rate of 13.2% (n = 140). In multiple logistic regression with penalization, the independent predictors of death were “predisposition”: malignancy (β-coefficient, 0.65; +2 points); “infection”: Staphylococcus aureus (S. aureus) bacteremia (0.69; +2 points), pneumonia (1.32; +4 points), and bacteremia with an unknown focus (0.70; +2 points); “response”: body temperature <36°C (1.17; +3 points), band form >5% (1.00; +3 points), and red blood cell distribution width (RDW) >15% (0.63; +2 points); and “organ dysfunction”: pulse oximeter oxygen saturation <90% (0.72; +2 points) and creatinine >2 mg/dL (0.69; +2 points). The area under receiver operating characteristic curve (AUROC) for the model was 0.881 [95% confidence interval (CI), 0.848–0.913], with a better performance than the Pitt bacteremia score (AUROC: 0.750; 95% CI 0.699–0.800, p < 0.001). The patients were stratified into four risk groups: (1) low, 0–3 points, mortality rate: 1.5%; (2) moderate, 4–6 points, mortality rate: 10.5%; (3) high, 7–8 points, mortality rate: 28.6%; and (4) very high, ≥9 points, mortality rate: 65.5%.ConclusionThe new scoring system for bacteremia could facilitate the prediction of the risk of 28-day mortality for patients visiting the ED with BSI.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Microbiology, Immunology and Infection - Volume 47, Issue 6, December 2014, Pages 469–477
نویسندگان
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