Validation of a predictive model for bacteraemia (MPB5-Toledo) in the patients seen in emergency departments due to infections
Por:
Julian-Jimenez, A, Garcia-Lamberechts, EJ, del Castillo, JG, Bustos, CN, Llopis-Roca, F, de Zarate, MMO, Salmeron, PP, Tey, JMG, Alvarez-Manzanares, J, Gamazo-Del Rio, JJ, Sanz, IH, Diaz, RR, Alonso, MA, Ordonez, BM, Lopez, OA, Romero, MDO, Gonzalez, FJC
Publicada:
1 mar 2022
Ahead of Print:
1 mar 2022
Resumen:
Objective: To validate a simple risk score to predict bacteremia (MPB5-Toledo) in patients seen in the emergency departments (ED) due to infections.
Methods: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered in 74 Spanish ED for adults (aged 18 or older) seen from from October 1, 2019, to February 29, 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 cut-off values chosen for getting the sensitivity, specificity, positive predictive value and negative predictive value.
Results: A total of 3.843 blood samples wered cultured. True cases of bacteremia were confirmed in 839 (21.83%). The remaining 3.004 cultures (78.17%) were negative. Among the negative, 172 (4.47%) were judged to be contaminated. Low risk for bacteremia was indicated by a score of 0 to 2 points, intermediate risk by 3 to 5 points, and high risk by 6 to 8 points. Bacteremia in these 3 risk groups was predicted for 1.5%, 16.8%, and 81.6%, respectively. The model's area under the receiver operating characteristic curve was 0.930 (95% CI, 0.916-0.948). The prognostic performance with a model's cut-off value of > 5 points achieved 94.76% (95% CI: 92.97-96.12) sensitivity, 81.56% (95% CI: 80.11-82.92) specificity, and negative predictive value of 98.24% (95% CI: 97.62-98.70).
Conclusion: The 5MPB-Toledo score is useful for predicting bacteremia in patients attended in hospital emergency departments for infection. (C) 2021 Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Julian-Jimenez, A:
Complejo Hosp Univ Toledo, Serv Urgencias, Toledo, Spain
Garcia-Lamberechts, EJ:
IDISSC, Serv Urgencias, Hosp Univ Clin San Carlos, Madrid, Spain
del Castillo, JG:
IDISSC, Serv Urgencias, Hosp Univ Clin San Carlos, Madrid, Spain
Bustos, CN:
Hosp Univ Virgen de la Macarena, Serv Urgencias, Seville, Spain
Llopis-Roca, F:
Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain
de Zarate, MMO:
Hosp Univ Basurto, Serv Urgencias, Bilbao, Vizcaya, Spain
Salmeron, PP:
Hosp Univ Reina Sofia, Serv Urgencias, Murcia, Spain
Tey, JMG:
Hosp Univ St Pau, Serv Urgencias, Barcelona, Spain
Alvarez-Manzanares, J:
Hosp Univ Rio Hortega, Serv Urgencias, Valladolid, Spain
Gamazo-Del Rio, JJ:
Hosp Univ Galdakao Usansolo, Serv Urgencias, Galdakao, Bizkaia, Spain
Sanz, IH:
Hosp Univ Donosti, Serv Urgencias, Donostia San Sebastian, Guipuzcoa, Spain
Diaz, RR:
Complejo Hosp Univ Toledo, Serv Urgencias, Toledo, Spain
Alonso, MA:
Hosp Univ Fuenlabrada, Serv Urgencias, Madrid, Spain
Ordonez, BM:
Hosp Virgen de la Victoria, Serv Urgencias, Malaga, Spain
Lopez, OA:
Hosp Univ Mostoles, Serv Urgencias, Madrid, Spain
Romero, MDO:
Hosp Clin Barcelona, Serv Urgencias, Barcelona, Spain
Gonzalez, FJC:
IDISSC, Serv Microbiol Clin, Hosp Univ Clin San Carlos, Madrid, Spain
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