RESUMO
OBJECTIVE: To analyse a new risk score to predict bacteremia (MPB-INFURG-SEMES) in the patients with solid tumor attender for infection in the emergency departments (ED). METHODS: Prospective, multicenter observational cohort study of blood cultures (BC) obtained from adult patients with solid neoplasia treated in 63 EDs for infection from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the chosen cut-off for getting the sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: A total of 857 blood samples wered cultured. True cases of bacteremia were confirmed in 196 (22.9%). The remaining 661 cultures (77.1%) wered negative. And, 42 (4.9%) were judged to be contaminated. The model's area under the receiver operating characteristic curve was 0.923 (95% CI,0.896-0.950). The prognostic performance with a model's cut-off value of ≥ 5 points achieved 95.74% (95% CI, 94,92-96.56) sensitivity, 76.06% (95% CI, 75.24-76.88) specificity, 53.42%(95% CI, 52.60-54.24) positive predictive value and 98.48% (95% CI, 97.66- 99.30) negative predictive value. CONCLUSIONS: The MPB-INFURG-SEMES score is useful for predicting bacteremia in the adults patients with solid tumor seen in the ED.
Assuntos
Bacteriemia , Serviço Hospitalar de Emergência , Neoplasias , Humanos , Bacteriemia/microbiologia , Bacteriemia/tratamento farmacológico , Neoplasias/complicações , Estudos Prospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Curva ROC , Prognóstico , Adulto , Sensibilidade e Especificidade , Hemocultura , Valor Preditivo dos Testes , Medição de Risco , Estudos de CoortesRESUMO
We report a patient with segmental portal hypertension secondary to a retroperitoneal tuberculous abscess. The patient was admitted to the hospital because of upper gastrointestinal bleeding. Gastric varices were the only lesion found at endoscopy. At laparotomy a retroperitoneal abscess was found as the etiology of splenic vein thrombosis. We emphasize the low frequency of this finding and its resolution after splenectomy and antituberculous drugs.