Predictive model for bacteremia in adult patients with blood cultures performed at the emergency department

A preliminary report

Chan Ping Su, Tony Hsiu Hsi Chen, Shey Ying Chen, Wen Chu Ghiang, Grace Hwei Min Wu, Hsin Yun Sun, Chien Cheng Lee, Jiun Ling Wang, Shan Chwen Chang, Yee Chun Chen, Amy Ming Fang Yen, Wen Jone Chen, Po Ren Hsueh

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Useful predictive models for identifying patients at high risk of bacteremia at the emergency department (ED) are lacking. This study attempted to provide useful predictive models for identifying patients at high risk of bacteremia at the ED. Methods: A prospective cohort study was conducted at the ED of a tertiary care hospital from October 1 to November 30, 2004. Patients aged 15 years or older, who had at least two sets of blood culture, were recruited. Data were analyzed on selected covariates, including demographic characteristics, predisposing conditions, clinical presentations, laboratory tests, and presumptive diagnosis, at the ED. An iterative procedure was used to build up a logistic model, which was then simplified into a coefficient-based scoring system. Results: A total of 558 patients with 84 episodes of true bacteremia were enrolled. Predictors of bacteremia and their assigned scores were as follows: fever greater than or equal to 38.3°C [odds ratio (OR), 2.64], 1 point; tachycardia greater than or equal to 120/min (OR, 2.521), 1 point; lymphopenia less than 0.5×10 3/μL (OR, 3.356), 2 points; aspartate transaminase greater than 40IU/L (OR, 2.355), 1 point; C-reactive protein greater than 10mg/dL (OR, 2.226), 1 point; procalcitonin greater than 0.5ng/mL (OR, 3.147), 2 points; and presumptive diagnosis of respiratory tract infection (OR, 0.236), -2 points. The area under the receiver operating characteristic curves of the original logistic model and the simplified scoring model using the aforementioned seven predictors and their assigned scores were 0.854 (95% confidence interval, 0.806-0.902) and 0.845 (95% confidence interval, 0.798-0.894), respectively. Conclusion: This simplified scoring system could rapidly identify high-risk patients of bacteremia at the ED.

Original languageEnglish
Pages (from-to)449-455
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Volume44
Issue number6
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

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Bacteremia
Hospital Emergency Service
Odds Ratio
Logistic Models
Confidence Intervals
Lymphopenia
Calcitonin
Tertiary Healthcare
Aspartate Aminotransferases
Blood Culture
Tertiary Care Centers
Tachycardia
ROC Curve
Respiratory Tract Infections
C-Reactive Protein
Cohort Studies
Fever
Demography
Prospective Studies

Keywords

  • Bacteremia
  • Blood cultures
  • Emergency department
  • Predictive model

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Infectious Diseases

Cite this

Predictive model for bacteremia in adult patients with blood cultures performed at the emergency department : A preliminary report. / Su, Chan Ping; Chen, Tony Hsiu Hsi; Chen, Shey Ying; Ghiang, Wen Chu; Wu, Grace Hwei Min; Sun, Hsin Yun; Lee, Chien Cheng; Wang, Jiun Ling; Chang, Shan Chwen; Chen, Yee Chun; Yen, Amy Ming Fang; Chen, Wen Jone; Hsueh, Po Ren.

In: Journal of Microbiology, Immunology and Infection, Vol. 44, No. 6, 12.2011, p. 449-455.

Research output: Contribution to journalArticle

Su, Chan Ping ; Chen, Tony Hsiu Hsi ; Chen, Shey Ying ; Ghiang, Wen Chu ; Wu, Grace Hwei Min ; Sun, Hsin Yun ; Lee, Chien Cheng ; Wang, Jiun Ling ; Chang, Shan Chwen ; Chen, Yee Chun ; Yen, Amy Ming Fang ; Chen, Wen Jone ; Hsueh, Po Ren. / Predictive model for bacteremia in adult patients with blood cultures performed at the emergency department : A preliminary report. In: Journal of Microbiology, Immunology and Infection. 2011 ; Vol. 44, No. 6. pp. 449-455.
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AU - Lee, Chien Cheng

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