Risk Models of Harrison et al for Invasive Candidiasis in a Non-Neutropenic Adult in the Intensive Care Unit (ICU): Model for 24 Hours After Admission to the ICU
Harrison et al reported risk models for invasive Candidiasis in a non-neutropenic adult in the intensive care unit (ICU). One model deals with information collected 24 hours after admission to the ICU. The authors are from multiple institutions in the United Kingdom and participants in the Fungal Infection Risk Evaluation (FIRE) study.
Patient selection: ICU, non-neutropenic adult
Parameters:
(1) history of surgery <= 7 days prior to admission
(2) pancreatitis
(3) number of central venous catheters
(4) number of drains
(5) lowest systolic blood pressure during past 24 hours since admission in mm Hg
(6) highest heart rate during first 24 hours in the ICU in beats per minute
(7) number of samples positive for fungal colonization prior to admission
Parameter
Finding
Beta-Coefficient
history of surgery
none
0.89
elective
0
emergency or urgent surgery
0.89
pancreatitis
no
0
yes
1.22
number of CVCs
0
0
1
1.35
2
2.60
number of drains
0
0
1 to 3
0.71
4
2.09
minimum SBP
>= 90 mm Hg
0
< 90 mm Hg
0.55
maximum heart rate
< 100 beats per minute
0
>= 100 beats per minute
0.85
number of positive samples
0
0
>=1
1.87
value of X =
= SUM(points for all 7 parameters) - 8.96
probability of invasive Candidiasis while in ICU =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.82 in the derivation and 0.72 in the validation cohort.
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