Chen et al developed a simple score for identifying an adult with nontyphoid Salmonella bacteremia who may have a vascular invasion. These can help to identify a patient who may benefit from more aggressive management. The authors are from National Cheng Kung University Hospital, Chi Mei Medical Center and Chia Nan University of Pharmacy and Science in Taiwan.
Patient selection: bacteremia with Salmonella species other than typhi
Outcome: vascular infection
Parameters:
(1) hypertension
(2) gender
(3) serogroup C1 nontyphoid Salmonella
(4) coronary artery disease
(5) malignancy
(6) immunosuppressive therapy
|
Parameter |
Finding |
Points |
|
hypertension |
No |
0 |
|
|
Yes |
1 |
|
gender |
Female |
0 |
|
|
Male |
1 |
|
serogroup C1 |
No |
0 |
|
|
Yes |
1 |
|
coronary artery disease |
No |
0 |
|
|
Yes |
1 |
|
malignancy |
No |
0 |
|
|
Yes |
-1 |
|
immunosuppressive therapy |
No |
0 |
|
|
yes |
-1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -2
• maximum score: 4
• The higher the score the greater the risk of vascular infection.
|
Total Score |
Prevalence Vascular Infection |
|
<= 0 |
2.2% |
|
1 |
10.6% |
|
2 |
39.4% |
|
3 |
55.2% |
|
4 |
100% |
Performance:
• The area under the ROC curve is 0.83.
• A cutoff of +1 has a sensitivity of 95% and specificity of 45%.
Specialty: Infectious Diseases, Gastroenterology, Nutrition
