Tumbarello et al developed a score for predicting mortality in a bacteremic patient with a hematological malignancy. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals in Italy and members of HeMABIS (Hematological Malignancies Associated Bacterial Infections Surveillance).
Patient selection: bacteremia and hematological malignancy
Outcome: mortality
Parameters:
(1) acute renal failure
(2) severe neutropenia (absolute neutrophil count < 100 per µL)
(3) nosocomial bacteremia
(4) age in years
(5) Charlson Comorbidity Index (CCI)
Parameter
Finding
Points
acute renal failure
absent
0
present
1
severe neutropenia
absent
0
present
1
nosocomial bacteremia
no
0
yes
1
age in years
< 65 years
0
>= 65 years
1
Charlson Comorbidity
0 to 3
0
>= 4
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk of mortality.
Score
Mortality Rate
0
0%
1
5%
2
24%
3
61%
4
58%
5
100%
Performance:
• The area under the ROC curve was 0.83 for the derivation set and 0.93 for the validation set.
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