Details

Autor(en) / Beteiligte

• Falguera, Miquel
• Trujillano, Javier
• Caro, Sílvia
• Menéndez, Rosario
• Carratalà, Jordi
• Ruiz-González, Agustín
• Vilà, Manuel
• García, Mercè
• Porcel, José Manuel
• Torres, Antoni

Titel

A Prediction Rule for Estimating the Risk of Bacteremia in Patients with Community-Acquired Pneumonia

Ist Teil von

• Clinical infectious diseases, 2009-08, Vol.49 (3), p.409-416

Ort / Verlag

Oxford: The University of Chicago Press

Erscheinungsjahr

2009

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. We endeavored to construct a simple score based entirely on epidemiological and clinical variables that would stratify patients who require hospital admission because of community-acquired pneumonia into groups with a low or high risk of developing bacteremia. Methods. Derivation and internal validation cohorts were obtained by retrospective analysis of a database that included 3116 consecutive patients with community-acquired pneumonia from 2 university hospitals. Potential predictive factors were determined by means of a multivariate logistic regression equation applied to a cohort consisting of 60% of the patients. Points were assigned to significant parameters to generate the score. It was then internally validated with the remaining 40% of patients and was externally validated using an independent multicenter cohort of 1369 patients. Results. The overall rates of bacteremia were 12%-16% in the cohorts. The clinical probability estimate of developing bacteremia was based on 6 variables: liver disease, pleuritic pain, tachycardia, tachypnea, systolic hypotension, and absence of prior antibiotic treatment. For the score, 1 point was assigned to each predictive factor. In the derivation cohort, a cutoff score of 2 best identified the risk of bacteremia. In the validation cohorts, rates of bacteremia were <8% for patients with a score ⩽1 (43%-49% of patients), whereas blood culture results were positive in 14%-63% of cases for patients with a score ⩾2. Conclusions. This clinical score, based on readily available and objective variables, provides a useful tool to predict bacteremia. The score has been internally and externally validated and may be useful to guide diagnostic decisions for community-acquired pneumonia.