Predicting bacteremia at the bedside.
Our aim was to develop a clinical prediction rule for detection of bacteremia in a cohort of patients observed prospectively at a reference center in Medellín, Colombia. The significant predictors of bacteremia were an age of >or=30 years (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.19-3.60), a heart rate of >or=90 beats/min (OR, 1.90; 95% CI, 1.13-3.17), a temperature of >or=37.8 degrees C (OR, 2.42; 95% CI, 1.41-4.14), a leukocyte count of >or=12,000 cells/microL (OR, 2.40; 95% CI, 1.41-4.10), use of a central venous catheter (OR, 1.89; 95% CI, 1.02-3.50), and a length of hospitalization of >or=10 days (OR, 2.02; 95% CI, 1.25-3.24). The Hosmer-Lemeshow test revealed a goodness-of-fit of 2.99 (P=.981), and the area under the receiver operating characteristics curve was 0.7186. Simple variables obtained from the clinical history of patients are associated with bloodstream infection in a reproducible fashion and should be instrumental for prioritizing the requests for blood cultures by clinicians.
Jaimes
Fabián
F
Department of Internal Medicine and Escuela de Investigaciones Médicas Aplicadas, School of Medicine, University of Antioquia, Medellín, Colombia. fjaimesb@jhsph.edu
Arango
Clara
C
Ruiz
Giovanni
G
Cuervo
Jorge
J
Botero
Juan
J
Vélez
Gloria
G
Upegui
Natalia
N
Machado
Faber
F
D000328:Adult; D000367:Age Factors; D016470:Bacteremia / Q000175:diagnosis* / Q000453:epidemiology; D001831:Body Temperature; D002405:Catheterization, Central Venous; D003105:Colombia / Q000453:epidemiology; D005260:Female; D006339:Heart Rate; D006801:Humans; D007902:Length of Stay; D007962:Leukocytes; D008297:Male; D011237:Predictive Value of Tests