Risk Factors for Septic Shock in Patient with Bacteremia

 

Parameters:

(1) age and gender

(2) serum creatinine

(3) prothrombin time

(4) interstitial pattern on chest X-ray

 

Parameter	Finding	Points
age and gender	female	0
	male and <= 75 years	0
	male and > 75 years	1
serum creatinine	<= 2.0 mg/dL	0
	> 2.0 mg/dL	1
prothrombin time	>= 60%	0
	< 60%	1
interstitial pattern on chest X-ray	none	0
	<= 50%	0
	> 50%	1

 

where:

• Reporting the prothrombin time in percent is done in Europe but not the US. The corresponding PT in seconds can be determined by diluting the sample with factor deficient plasma.

• Most of these findings reflect some type of organ dysfunction (interstitial pattern and CHF, decreased prothrombin time and coagulopathy).

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

• The risk of septic shock increases with the number of risk factors.

 

Performance:

• The positive predictive value was 55% and the negative predictive value was 89%. 77% of patients were accurately classified.

 

Other significant factors associated with septic shock:

(1) WBC count > 20,000 per µL

 

Findings associated with an increased risk of death:

(1) body temperature was < 38°C

(2) bacteremia with Pseudomonas aeruginosa or Streptococcus pneumoniae