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Description

Al-Hasan et al developed the bloodstream infection mortality risk score (BSIMRS) to evaluate a patient with Gram-negative bloodstream infection. The authors are from the University of South Carolina, Mayo Clinic Rochester, and Soonchunhyang University in Seoul.


 

Patient selection: Gram-negative bacteria

 

Parameters:

(1) malignancy

(2) liver cirrhosis

(3) source of infection

(4) Pitt Bacteremia Score of Paterson et al (from 0 to 14)

 

Parameter

Finding

Points

Malignancy

absent

0

 

present

3

Cirrhosis

absent

0

 

present

4

source of infection

urinary tract or central venous catheter

0

 

other

4

Pitt bacteremia score

0 or 1

0

 

2 or 3

2

 

>= 4

5

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 16

• The higher the score the greater the 28-day mortality.

 

If the data in Figure 2 (Al-Hasan, 2014) is analyzed:

 

X =

= (0.4502 * (score)) - 4.152

 

probability of 28-day mortality =

= 1 / (1 + EXP((-1) * X))

 

Performance:

• The area under the ROC curve was 0.86.

• A score >= 5 had a sensitivity of 74% and specificity of 87% for 28 day mortality, with a negative predictive value of 97%.

 


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