External validation of ID-BactER and Shapiro scores for predicting bacteraemia in the emergency department.
| Autor: | Quintero Montealegre S; Department of Internal Medicine, Hospital Universitario San Ignacio, Carrera 7 No 40-62, 7th Floor, Bogotá 110231, Colombia., Flórez Monroy AF; Department of Internal Medicine, Pontifical Xavierian University, Bogotá, Colombia., Garzón Herazo JR; Department of Internal Medicine, Pontifical Xavierian University, Bogotá, Colombia.; Infectious Diseases Unit, Hospital Universitario San Ignacio, Bogotá, Colombia., Perez Mendez W; School of Medicine, Pontifical Xavierian University, Bogotá, Colombia., Piraquive NM; School of Medicine, Pontifical Xavierian University, Bogotá, Colombia., Cortes Fraile G; Department of Microbiology, Hospital Universitario San Ignacio, Bogotá, Colombia., Muñoz Velandia OM; Department of Internal Medicine, Pontifical Xavierian University, Bogotá, Colombia.; Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Therapeutic advances in infectious disease [Ther Adv Infect Dis] 2024 Dec 07; Vol. 11, pp. 20499361241304508. Date of Electronic Publication: 2024 Dec 07 (Print Publication: 2024). |
| DOI: | 10.1177/20499361241304508 |
| Abstrakt: | Introduction: The blood culture positivity rate in the emergency department (ED) is <20%; however, the mortality associated with Community-acquired bacteraemia (CAB) is as high as 37.8%. For this reason, several models have been developed to predict blood culture positivity for the diagnosis of CAB. Objective: To validate two bacteraemia prediction models in a high-complexity hospital in Colombia. Design: External validation study of the ID-BactER and Shapiro scores based on a consecutive cohort of patients who underwent blood culture within 48 h of ED admission. Methods: Scale calibration was assessed by comparing expected and observed events (calibration belt). Discriminatory ability was assessed by area under the ROC curve (AUC-ROC). Results: We included 1347 patients, of whom 18.85% were diagnosed with CAB. The most common focus of infection was the respiratory tract (36.23%), and the most common microorganism was Escherichia coli (52.15%). The Shapiro score underestimated the risk in all categories and its discriminatory ability was poor (AUC 0.68 CI 95% 0.64-0.73). In contrast, the ID-BactER score showed an adequate observed/expected event ratio of 1.07 (CI 0.85-1.36; p = 0.018) and adequate calibration when expected events were greater than 20%, in addition to good discriminatory ability (AUC 0.74 95% CI 0.70-0.78). Conclusion: The Shapiro score is not calibrated, and its discriminatory ability is poor. ID-BactER has an adequate calibration when the expected events are higher than 20%. Limiting blood culture collection to patients with an ID-BactER score ⩾4 could reduce unnecessary blood culture collection and thus health care costs. (© The Author(s), 2024.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|