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Rev Esp Quimioter 2021; May 25

Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with community-acquired pneumonia in the Emergency Department

AGUSTÍN JULIÁN-JIMÉNEZ, JUAN GONZÁLEZ DEL CASTILLO, ERIC JORGE GARCÍA-LAMBERECHTS, RAFAEL RUBIO DÍAZ, ITZIAR HUARTE SANZ, CARMEN NAVARRO BUSTOS, FRANCISCO JAVIER MARTÍN-SÁNCHEZ, FRANCISCO JAVIER CANDEL GONZÁLEZ, EN NOMBRE DEL GRUPO INFURG-SEMES

Published: 25 May 2021

http://www.doi.org/10.37201/req/043.2021

Objective. To analyse a new risk score to predict bacteremia in the patients with Community-acquired Pneumonia (CAP) in the emergency departments.
Patients and methods. Prospective and multicenter observational cohort study of the blood cultures ordered in 74 Spanish emergency departments for patients with CAP seen from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the chosen cut-off for getting the sensitivity, specificity, positive predictive value and negative predictive value.
Results. A total of 1,020 blood samples wered cultured. True cases of bacteremia were confirmed in 162 (15.9%). The remaining 858 cultures (84.1%) wered negative. And, 59 (5.8%) were judged to be contaminated. The model´s area under the receiver operating characteristic curve was 0.915 (95% CI, 0.898-0.933). The prognostic performance with a model´s cut-off value of ≥ 5 points achieved 97.5% (95% CI, 95.1-99.9) sensitivity, 73.2% (95% CI, 70.2-76.2) specificity, 40.9% (95% CI, 36.4-45.1) positive predictive value and 99.4% (95% CI, 99.1-99.8) negative predictive value.
Conclusion. The 5MPB-Toledo score is useful for predicting bacteremia in the patients with CAP seen in the emergency departments.

Rev Esp Quimioter 2021; May 25 [Texto completo PDF]