RESUMEN
BACKGROUND: To develop a prediction rule to describe the risk of death as a result of enterococcal bloodstream infection. METHODS: A prediction rule was developed by analysing data collected from 122 patients diagnosed with enterococcal BSI admitted to the Clínica Universidad de Navarra (Pamplona, Spain); and validated by confirming its accuracy with the data of an external population (Hospital del Mar, Barcelona). RESULTS: According to this model, independent significant predictors for the risk of death were being diabetic, have received appropriate treatment, severe prognosis of the underlying diseases, have renal failure, received solid organ transplant, malignancy, source of the bloodstream infection and be immunosuppressed. The prediction rule showed a very good calibration (Hosmer-Lemeshow statistic, P = 0.93) and discrimination for both training and testing sets (area under ROC curve = 0.84 and 0.83 respectively). CONCLUSIONS: The predictive rule was able to predict risk of death as a result of enterococcal bloodstream infection as well as to identify patients, who being below the threshold value, will have a low risk of death with a negative predictive value of 96%.
Asunto(s)
Bacteriemia/microbiología , Bacteriemia/mortalidad , Técnicas de Apoyo para la Decisión , Enterococcus/aislamiento & purificación , Anciano , Comorbilidad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Curva ROC , Medición de Riesgo/métodos , Factores de Riesgo , EspañaRESUMEN
BACKGROUND: To analyze predictors of mortality and poor outcome in cancer patients diagnosed with E. faecium bloodstream infection. METHODS: Demographic, clinical and microbiological data were collected (January 1998-June 2011). RESULTS: After multivariate analysis, presence of a urinary catheter was associated with a worse 7-day prognosis, and higher mortality at discharge. A high Charlson index was also associated with higher 7-day mortality. CONCLUSION: Presence of a urinary catheter was associated with poor 7-day prognosis and higher mortality at discharge in the present series.
Asunto(s)
Bacteriemia/complicaciones , Bacteriemia/mortalidad , Enterococcus faecium , Infecciones por Bacterias Grampositivas/complicaciones , Infecciones por Bacterias Grampositivas/mortalidad , Neoplasias/complicaciones , Neoplasias/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
Background: To analyze predictors of mortality and poor outcome in cancer patients diagnosed with E. faecium bloodstream infection. Methods: Demographic, clinical and microbiological data were collected (January 1998-June 2011). Results: After multivariate analysis, presence of a urinary catheter was associated with a worse 7-day prognosis, and higher mortality at discharge. A high Charlson index was also associated with higher 7-day mortality. Conclusion: Presence of a urinary catheter was associated with poor 7-day prognosis and higher mortality at discharge in the present series (AU)
Fundamento: Analizar los predictores de mortalidad y mal pronóstico en el paciente oncológico diagnosticado de bacteriemia por E. faecium. Métodos: Se analizaron datos demográficos, clínicos y microbiológicos (Enero 1998-Junio 2011). Resultados: El análisis multivariable demostró que la presencia de una sonda urinaria se asoció a mal pronóstico a los 7 días y alta mortalidad del paciente al final del estudio. Un índice de Charlson elevado se asoció a un aumento en la mortalidad a los 7 días. Conclusión: En nuestro estudio, la presencia de sonda urinaria se asoció con mal pronóstico del paciente a los 7 días y aumento de la mortalidad (AU)