We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Prospective Validation of PREDICT and Its Impact on the Transesophageal Echocardiography Use in Management of Staphylococcus aureus Bacteremia.
- Authors
Saleh, Omar Abu; Fida, Madiha; Asbury, Kara; Narichania, Aalap; Sotello, David; Bosch, Wendelyn; Vikram, Holenarasipur R; Palraj, Raj; Lahr, Brian; Baddour, Larry M; Sohail, M Rizwan
- Abstract
Background Infective endocarditis (IE) is the most feared complication of Staphylococcus aureus bacteremia (SAB). Transesophageal echocardiogram (TEE) is generally recommended for all patients with SAB; however, supporting data for this are limited. We previously developed a scoring system, "PREDICT," that quantifies the risk of IE and identifies patients who would most benefit most from undergoing TEE. The current prospective investigation aims to validate this score. Methods We prospectively screened all consecutive adults (≥18 years) hospitalized with SAB at 3 Mayo Clinic sites between January 2015 and March 2017. Results Of 220 patients screened, 199 with SAB met study criteria and were included in the investigation. Of them, 23 (11.6%) patients were diagnosed with definite IE within 12 weeks of initial presentation based on modified Duke's criteria. Using the previously derived PREDICT model, the day 1 score of ≥4 had a sensitivity of 30.4% and a specificity of 93.8%, whereas a day 5 score of ≤2 had a sensitivity and negative-predictive value of 100%. Additional factors including surgery or invasive procedure in the past 30 days, prosthetic heart valve, and higher number of positive blood culture bottles in the first set of cultures were associated with increased risk of IE independent of the day 5 risk score. Conclusions We validated the previously developed PREDICT scoring tools for stratifying risk of IE, and the need for undergoing a TEE, among cases of SAB. We also identified other factors with predictive potential, although larger prospective studies are needed to further evaluate possible enhancements to the current scoring system.
- Subjects
ENDOCARDITIS prevention; BACTEREMIA; TRANSESOPHAGEAL echocardiography; RESEARCH methodology evaluation; RESEARCH methodology; STAPHYLOCOCCAL diseases; RISK management in business; LONGITUDINAL method; DISEASE complications
- Publication
Clinical Infectious Diseases, 2021, Vol 73, Issue 7, pe1745
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa844