Model of Chase et al for Predicting Gram Negative Bacteremia in a Patient in the Emergency Department

Description

Chase et al developed 3 models for predicting bacteremia in patients in the Emergency Department (ED). One model predicted the probability of bacteremia with a Gram-negative bacterium. The authors are from Beth Israel Deaconess Medical Center in Boston.

Patient selection: patient in the Emergency Department with suspected bacteremia

Parameters:

(1) suspected urinary source

(2) indwelling venous catheter

(3) vasopressors in the Emergency Department

(4) temperature

(5) platelet count

(6) percent neutrophils in the differential count

(7) bandemia

Parameters	Finding	Points
suspected urinary source	no	0
	yes	1.39
indwelling venous catheter	no	0
	yes	0.67
vasopressors in the ED	no	0
	yes	1.03
temperature	normal	0
	abnormal (< 96.8 or > 100.4°F)	0.71
platelet count	>= 150,000 per µL	0
	< 150,000 per µL	0.68
percent neutrophils	<= 80%	0
	> 80%	0.50
bandemia	no	0
	yes (> 5%)	1.25

where:

• Points are beta-coefficients for the model.

X =

= SUM(points for the 7 parameters) - 4.46

probability of Gram-negative bacteremia =

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

Performance:

• The area under the ROC curve was 0.75.

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Description

Specialty

ICD-10