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- Title
A new simplified predictive model for mortality in methicillin-resistant Staphylococcus aureus bacteremia.
- Authors
Jorgensen, Sarah C. J.; Lagnf, Abdalhamid M.; Bhatia, Sahil; Rybak, Michael J.
- Abstract
Adjustment for confounding is important in observational methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) studies due to the wide spectrum of disease severity and baseline health status that patients present with. The objectives of this study were to develop a simplified MRSAB-specific scoring model to estimate the risk of 30-day all-cause mortality and to compare its performance to the APACHE II and Pitt Bacteremia scores. Retrospective, singe-center, cohort study in adults with MRSAB 2008 to 2018. Independent predictors of mortality were identified through multivariable logistic regression. A scoring model was derived using a regression coefficient-based scoring method. Discriminatory ability was assessed using the c statistic. A total of 455 patients were included. Thirty-day mortality was 16.3%. The MRSAB score consisted of six variables: age, respiratory rate, Glasgow Coma scale, renal failure, hospital-acquired MRSAB, and infective endocarditis or lower respiratory tract infection source. The score demonstrated very good discrimination (c statistic 0.8662, 95% CI 0.824–0.909) and was superior to the APACHE II (P = 0.043) and the Pitt bacteremia (P < 0.001) scores. A weighted combination of six independent variables routinely measured in patients with MRSAB can be used to predict, with high discrimination, 30-day all-cause mortality. External validation is required before widespread use.
- Subjects
METHICILLIN-resistant staphylococcus aureus; PREDICTION models; BACTEREMIA; BACTERIAL disease risk factors; MORTALITY
- Publication
European Journal of Clinical Microbiology & Infectious Diseases, 2019, Vol 38, Issue 5, p843
- ISSN
0934-9723
- Publication type
Article
- DOI
10.1007/s10096-018-03464-0