Shao et al identified risk factors for stroke in a patient with sepsis or bloodstream infection. The authors are from Columbia University.
Patient selection: sepsis or bloodstream infection
Outcome: 1-year risk of stroke (which is beyond the acute period of bacteremia)
Parameters:
(1) valvular heart disease
(2) congestive heart failure (CHF)
(3) renal failure
(4) malignant lymphoma
(5) peripheral vascular disease
(6) pulmonary circulation disorder
(7) coagulopathy (thrombocytopenia, qualitative platelet defect, antithrombotic coagulation defect, thrombotic, DIC)
|
Parameter
|
Finding
|
Points
|
|
valvular heart disease
|
absent
|
0
|
|
|
present
|
1
|
|
congestive heart failure
|
absent
|
0
|
|
|
present
|
1
|
|
renal failure
|
absent
|
0
|
|
|
present
|
1
|
|
malignant lymphoma
|
absent
|
0
|
|
|
present
|
2
|
|
peripheral vascular disease
|
absent
|
0
|
|
|
present
|
2
|
|
pulmonary circulatory disorder
|
absent
|
0
|
|
|
present
|
2
|
|
coagulopathy
|
absent
|
0
|
|
|
present
|
3
|
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk of stroke within in 1 year.
|
Score
|
Percent with Stroke
|
|
0 to 3
|
0.4%
|
|
4 to 6
|
1.3%
|
|
7 to 11
|
2.8%
|
|
12
|
NA
|
Performance:
• The area under the ROC curve is 0.68.
