Introduction

Bacteremia is a major cause of morbidity and mortality in hospitalized patients. Predictors of mortality are critical for the management and survival of hospitalized patients. The objective of this study was to determine the factors related to blood culture positivity and the risk factors for mortality in patients whose blood cultures were collected.

Methods

A prospective 2-cohort study (derivation with 784 patients and validation with 380 patients) based on the Pitt bacteremia score for all patients undergoing blood culture collection. The score was obtained from multivariate analysis. The Kaplan–Meier survival curve of the cohort derivation and the cohort validation groups was calculated, and the difference was assessed using a log-rank test. Mortality-related factors were older age, extended hospitalization, > 10% of immature cells in the leukogram, lower mean blood pressure, elevated heart rate, elevated WBC count, and elevated respiratory rate. These continuous variables were dichotomized according to their significance level, and a cut-off limit was created.

Results

The area under the ROC curve (AUC) was 0.789. The score was validated in a group of 380 patients who were prospectively evaluated.

Conclusion

Prolonged hospitalization, body temperature, and elevated heart rate were related to positive blood cultures. The Pitt score can be used to assess the risk of death; however it can be individualized according to the epidemiology of each hospital.

中文翻译：

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开发和验证用于预测菌血症和真菌血症患者血培养阳性和死亡率的风险评分

 介绍

菌血症是住院患者发病和死亡的主要原因。死亡率预测因子对于住院患者的管理和生存至关重要。本研究的目的是确定与血培养阳性相关的因素以及收集血培养的患者死亡的危险因素。

 方法

一项基于所有接受血培养采集患者的 Pitt 菌血症评分的前瞻性 2 队列研究（784 名患者的衍生研究和 380 名患者的验证）。分数是通过多变量分析获得的。计算队列推导组和队列验证组的 Kaplan-Meier 生存曲线，并使用对数秩检验评估差异。死亡相关因素包括年龄较大、住院时间延长、白细胞图中未成熟细胞> 10%、平均血压较低、心率升高、白细胞计数升高和呼吸频率升高。这些连续变量根据其显着性水平进行二分，并创建一个截止限值。

 结果

ROC曲线下面积（AUC）为0.789。该评分在 380 名接受前瞻性评估的患者中得到验证。

 结论

住院时间延长、体温升高和心率升高与血培养阳性有关。 Pitt评分可用于评估死亡风险；但可以根据各医院的流行病学情况进行个体化治疗。