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%.
Specialty: Infectious Diseases