Development and Validation of Nosocomial Bacterial Infection Prediction Models for Patients With Systemic Lupus Erythematosus.

Autor:	Restrepo Escobar M, Jaimes Barragán F; Grupo Académico de Epidemiología Clínica (GRAEPIC), Universidad de Antioquia, Medellín, Colombia., Vásquez Duque GM; From the Grupo de Reumatología de la Universidad de Antioquia (GRUA), Universidad de Antioquia, Medellín, Colombia., Aguirre Acevedo DC; Grupo Académico de Epidemiología Clínica (GRAEPIC), Universidad de Antioquia, Medellín, Colombia., Peñaranda Parada ÉA; Universidad Nacional de Colombia, Reumatólogo Clínica Colsanitas, Santafé de Bogotá, Bogotá, Colombia., Prieto-Alvarado J; Clínica Colsubsidio Calle 100, Santafé de Bogotá, Bogotá, Colombia., Mesa-Navas MA; Clínica el Rosario, Líder Área de Investigación En Reumatología SURA, Medellín, Colombia., Calle-Botero E; Clínica SOMER, Rionegro, Antioquia, Colombia., Arbeláez-Cortés Á; Clínica IMBANACO, Cali, Colombia., Velásquez-Franco CJ; Clínica Universitaria Bolivariana, Medellín, Colombia., Vergara-Serpa Ó; Clínica Universitaria Bolivariana, Medellín, Colombia., Del-Castillo-Gil DJ, Gordillo-González CA; Universidad del Valle, Cali, Colombia., Guzmán-Naranjo LC; Hospital Serena del Mar, Cartagena, Colombia., Granda-Carvajal PA; Servicios de Salud Suramericana, Medellín, Colombia., Jaramillo-Arroyave D; Universidad CES, Medellín, Colombia., Muñoz-Vahos CH, Vélez-Marín M; EPS SURA, Medellín, Colombia., Hernández-Zapata J; From the Grupo de Reumatología de la Universidad de Antioquia (GRUA), Universidad de Antioquia, Medellín, Colombia., Eraso-Garnica R, Vanegas-García AL, González-Naranjo LA; From the Grupo de Reumatología de la Universidad de Antioquia (GRUA), Universidad de Antioquia, Medellín, Colombia.
Jazyk:	angličtina
Zdroj:	Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases [J Clin Rheumatol] 2024 Oct 01; Vol. 30 (7), pp. 264-270. Date of Electronic Publication: 2024 Sep 12.
DOI:	10.1097/RHU.0000000000002120
Abstrakt:	Background: Hospital-acquired bacterial infections are associated with high morbidity and mortality rates in patients with systemic lupus erythematosus (SLE). This study aimed to develop and validate predictive models for the risk of hospital-acquired bacterial infections in patients with SLE. Methods: A historical cohort study was designed for development, and another bidirectional cohort study was used for external validation. The risk of bacterial infection was assessed upon admission and after 5 days of hospitalization. Predictor selection employed the least absolute shrinkage and selection operator (LASSO) techniques. Multiple imputations were used to handle missing data. Logistic regression models were applied, and the properties of discrimination, calibration, and decision curve analysis were evaluated. Results: The development cohort comprised 1686 patients and 237 events (14.1%) from 3 tertiary hospitals. The external validation cohort included 531 patients and 84 infection outcomes (15.8%) from 10 hospital centers in Colombia (secondary and tertiary level). The models applied at admission and after 120 hours of stay exhibited good discrimination (AUC > 0.74). External validation demonstrated good performance among patients from the same tertiary institutions where the models were developed. However, geographic validation at other institutions has been suboptimal. Conclusions: Two predictive models for nosocomial bacterial infections in patients with SLE are presented. All infection prevention recommendations should be maximized in patients at moderate/high risk. Further validation studies in diverse contexts, as well as clinical impact trials, are necessary before potential applications in research and clinical care. Competing Interests: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu