Leon et al developed a simple score for evaluation of a critically ill patient without neutropenia. This can help identify a patient who may benefit from early antifungal therapy. The authors are from multiple university hospitals in Spain.
Parameters:
(1) multifocal colonization with Candida species
(2) ICU admission following surgery
(3) severe sepsis
(4) total parenteral nutrition (TPN)
Parameter
Finding
Logistic Regression Model
Simplified Score
multifocal colonization
absent
0
0
present
1.112
1
ICU after surgery
no
0
0
yes
0.997
1
severe sepsis
absent
0
0
present
2.038
2
TPN
absent
0
0
present
0.908
1
Candida score =
= SUM(points for the logistic regression model)
simplified Candida score =
= SUM(points for the simplified score)
Although not mentioned in the paper, the probability for Candida infection should be calculated as:
X =
= (Candida score) - 4.916
probability =
= 1 / (1 + EXP((-1) * X))
Interpretation:
• minimum score: 0
• maximum Candida score: 5.055
• maximum simplified Candida score: 5
• A score > 2.5 indicates a patient who may benefit from early antifungal therapy.
Performance:
• At a score of 2.528 the sensitivity was 0.81 and specificity 0.74.
• The area under the ROC curve was 0.847.
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