title: Mortality risk score for Klebsiella pneumoniae bacteraemia.
abstract: BACKGROUND
  Klebsiella pneumoniae bacteraemia (KPB) has been associated with multiple risk factors. However association of these risk factors with mortality secondary to KPB has been poorly documented.
  
  
  OBJECTIVE
  To assess underlying co-morbidities in patients with KPB and any associated presentations. These findings were then used to devise a score to estimate the risk of in-hospital mortality in patients with underlying KPB.
  
  
  METHODS
  A retrospective analysis of all patients diagnosed with KPB between November 2007 and March 2012 at Mater Dei hospital in Malta was carried out. Using the odds ratios of risk factors for mortality associated with KPB, a mortality risk score was then prepared.
  
  
  RESULTS
  186 patients (mean age 62 years; mean hospital stay 22.6 days) were included. 51 patients died as inpatients. Being admitted to intensive care (Overall risk (OR): 9, p<0.0001), having a solid organ tumour (OR 3, p<0.005), and having an underlying pneumonia (OR 3, p<0.021) were statistically significant risk factors associated with mortality. There were 0% mortality in patients with a score of 0, and progressively increasing mortalities with increasing scores up to a 100% mortality in patients with scores of >15. This translated into a validated risk score where an increasing score reflected an increasing mortality.
  
  
  CONCLUSIONS
  Klebsiella pneumoniae bacteraemia is associated with high in-patient mortality. ICU admission, underlying solid tumours, and co-existent pneumonias are among the factors used in our mortality risk score. This needs to be further validated in larger populations.
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta. Electronic address: stf_che@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Chetcuti Zammit
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta.
authors.forename: N
authors.initials: N
authors.lastname: Azzopardi
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta.
authors.forename: J
authors.initials: J
authors.lastname: Sant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007710:Klebsiella Infections / Q000453:epidemiology / Q000401:mortality*; D007711:Klebsiella pneumoniae; D008297:Male; D008319:Malta / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D016017:Odds Ratio; D018410:Pneumonia, Bacterial / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Klebsiella pneumoniae; Mortality; Multidrug resistance; Risk score