Tacconelli et al reported several scores for predicting mortality in a patient with sepsis, with scores for 14-day and 6-month mortality. Each temporal view has a quick and a full model. The authors are from multiple institutions in Germany and Italy participating in the DZIF BLOOMY study group.
BLOOMY is an acronym for Bloodstream Infection due to multidrug-resistant Organisms: Multicenter Study on Risk Factors and Clinical Outcomes.
Patient selection: hospitalized adult with >= 1 blood culture positive for Staphylococcus aureus, Enterococcus species, E. coli, Klebsiella species, Enterobacter species, Pseudomonas aeruginosa and Acinetobacter baumannii.
Outcome: 6-month mortality
Parameters:
(1) body mass index (BMI) in kg per square meter
(2) age in years
(3) pathogen
(4) estimated eGFR in mL per min per 1.73 square meters
(5) hospital-acquired infection (HAI)
(6) malignancy status
(7) complications
(8) focus of infection
(9) platelet count per microliter
(10) CRP in mg/dL
(11) white blood cell count per microliter
|
Parameter |
Finding |
Points |
|
BMI |
<= 20 kg per sq m |
2 |
|
|
> 20 kg per sq m |
0 |
|
age in years |
< 80 years |
0 |
|
|
>= 80 years |
2 |
|
pathogen |
Staph. aureus, VR Enterococcus faecium, MDR GNR |
1 |
|
|
other |
0 |
|
eGFR |
> 60 mL/min/1.73 sq m |
0 |
|
|
<= 60 mL/min/1.73 sq m |
1 |
|
hospital-acquired infection |
no |
0 |
|
|
yes |
1 |
|
malignancy |
none |
0 |
|
|
chemotherapy |
5 |
|
|
metastases without chemotherapy |
4 |
|
|
neither chemo nor mets |
2 |
|
complications |
septic shock, liver failure, lung failure, renal failure |
1 |
|
|
thrombosis, decubitus, secondary dissemination, DIC |
2 |
|
|
none or other |
0 |
|
focus of infection |
abdominal |
1 |
|
|
respiratory |
2 |
|
|
other |
0 |
|
platelet count |
> 150,000 per µL |
0 |
|
|
50,001 to 150,000 |
2 |
|
|
<= 50,000 per µL |
3 |
|
CRP |
< 5 mg/dL |
0 |
|
|
5 to 19.99 mg/dL |
2 |
|
|
>= 20 mg/dL |
4 |
|
WBC count |
< 8,000 per µL |
0 |
|
|
8,000 to 12,999 per µL |
1 |
|
|
>= 13,000 per µL |
3 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 26
|
Score |
Mortality Rate in Derivation Cohort |
Mortality Rate in Validation Cohort |
|
0 to 2 |
1.3% |
5.7% |
|
3 to 8 |
18.4% |
20.5% |
|
>= 9 |
58% |
48.7% |
Performance:
• The area under the ROC curve was 0.81.
Specialty: Infectious Diseases
