Score of Palacios-Baena et al for Predicting Mortality in a Patient with Bloodstream Infection with an Extended Spectrum beta-Lactamase (ESBL) Producing Enterobacteriaceae (INCREMENT-ESBL Predictive Score)
Palacios-Baena et al repored a score for predicting 30-day mortality for a patient with a bloodstream infection due to an extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. The authors are from multiple institutions from around the world and participating in the REIPI/ESGBIS/INCREMENT group.
Patient selection: bloodstream infection with extended spectrum beta-lactamase producing Enterobacteriaceae
Outcome: 30-day mortality
Parameters:
(1) age in years
(2) species
(3) source for the infection
(4) underlying disease
(5) Pitt score (of Paterson et al, from 0 to 14)
(6) sepsis and sepsis shock at presentation
(7) early targeted therapy
Parameter
Finding
Points
age in years
<= 50 years
0
> 50 years
3
species
Klebsiella
2
other
0
source for the infection
urinary tract
0
other
3
underlying disease
none or nonfatal
0
fatal
4
Pitt score
<= 3
0
> 3
3
sepsis or septic shock
no
0
yes
4
early targeted therapy
appropriate
0
inappropriate
2
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the greater the risk of 30-day mortality.
Total Score
Mortality
0 to 10
5-6%
11 to 21
35-46%
based on derivation and validation cohorts
Performance:
• The area under the ROC curve was 0.82 to 0.85.
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