title: Bacteremia prediction model using a common clinical test in patients with community-acquired pneumonia.
abstract: OBJECTIVE
  The aim of this study was to construct a bacteremia prediction model using commonly available clinical variables in hospitalized patients with community-acquired pneumonia (CAP).
  
  
  METHODS
  A prospective database including patients who were diagnosed with CAP in the emergency department was analyzed. Independent risk factors were investigated by using multivariable analysis in 60% of the cohort. We assigned a weighted value to predictive factor and made a prediction rule. This model was validated both internally and externally with the remaining 40% of the cohort and a cohort from an independent hospital. The low-risk group for bacteremia was defined as patients who have a risk of bacteremia less than 3%.
  
  
  RESULTS
  A total of 2422 patients were included in this study. The overall rate of bacteremia was 5.7% in the cohort. The significant factors for predicting bacteremia were the following 7 variables: systolic blood pressure less than 90 mm Hg, heart rate greater than 125 beats per minute, body temperature less than 35 °C or greater than 40 °C, white blood cell less than 4000 or 12,000 cells per microliter, platelets less than 130,000 cells per microliter, albumin less than 3.3 g/dL, and C-reactive protein greater than 17 mg/dL. After using our prediction rule for the validation cohorts, 78.7% and 74.8% of the internal and external validation cohorts were classified as low-risk bacteremia groups. The areas under the receiver operating characteristic curves were 0.75 and 0.79 for the internal and external validation cohorts.
  
  
  CONCLUSIONS
  This model could provide guidelines for whether to perform blood cultures for hospitalized CAP patients with the goal of reducing the number of blood cultures.
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: Jungyoup
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon South Korea.
authors.forename: Seung Sik
authors.initials: SS
authors.lastname: Hwang
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital. Electronic address: dremkks@snubh.org.
authors.forename: Kyuseok
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: You Hwan
authors.initials: YH
authors.lastname: Jo
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: Joonghee
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: Joong Eui
authors.initials: JE
authors.lastname: Rhee
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: Chanjong
authors.initials: C
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital.
authors.forename: Heajin
authors.initials: H
authors.lastname: Chung
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine.
authors.forename: Jae Yun
authors.initials: JY
authors.lastname: Jung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000209:etiology; D001794:Blood Pressure; D001831:Body Temperature; D015331:Cohort Studies; D017714:Community-Acquired Infections; D016208:Databases, Factual; D003661:Decision Support Techniques; D004636:Emergency Service, Hospital; D005260:Female; D006339:Heart Rate; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors