Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with urinary tract infections in the emergency department.

Autor: Julián-Jiménez A; Servicio de Urgencias, Complejo Hospitalario Universitario de Toledo, Universidad de Castilla La Mancha, Toledo, Spain. Electronic address: agustinj@sescam.jccm.es., Rubio-Díaz R; Servicio de Urgencias, Complejo Hospitalario Universitario de Toledo, Universidad de Castilla La Mancha, Toledo, Spain., González Del Castillo J; Servicio de Urgencias, Hospital Universitario Clínico San Carlos, IDISSC, Madrid, Spain., Jorge García-Lamberechts E; Servicio de Urgencias, Hospital Universitario Clínico San Carlos, IDISSC, Madrid, Spain., Huarte Sanz I; Servicio de Urgencias, Hospital Universitario de Donosti, San Sebastián, Spain., Navarro Bustos C; Servicio de Urgencias, Hospital Universitario Virgen de la Macarena, Sevilla, Spain., Candel González FJ; Servicio de Microbiología Clínica, Hospital Universitario Clínico San Carlos, IDISSC, Madrid, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Actas urologicas espanolas [Actas Urol Esp (Engl Ed)] 2022 Dec; Vol. 46 (10), pp. 629-639. Date of Electronic Publication: 2022 Oct 21.
DOI: 10.1016/j.acuroe.2022.10.004
Abstrakt: Objective: To analyze the usefulness of a new predictive model of bacteremia (5MPB-Toledo) in patients treated for urinary tract infection (UTI) in the emergency department (ED).
Methods: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered for patients with UTIs in 65 Spanish ED from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The diagnostic performance was calculated with the chosen cut-off point for sensitivity, specificity, positive predictive value, and negative predictive value.
Results: A total of 1,499 blood cultures were evaluated. True cases of bacteremia were confirmed in 277 (18.5%). The remaining 1,222 cultures (81.5%) were negative. Ninety-four (6.3%) were considered contaminated. The model's area under the ROC curve was 0.937 (95% CI, 0.926-0.949). The prognostic performance with a model's cut-off value of ≥5 points achieved 97.47% (95% CI, 94.64-98.89) sensitivity, 76.68% (95% CI, 74.18-79.00) specificity, 48.65% (95% CI, 44.42-52.89) positive predictive value and 99.26% (95% CI, 98.41-99.67) negative predictive value.
Conclusion: The 5MPB-Toledo score is useful for predicting bacteremia in patients with UTIs who visit the ED.
(Copyright © 2022 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: