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Development and validation of a screening tool for early identification of bloodstream infection in older patients – a retrospective case-control study

BMC Geriatrics Jan 10, 2020

Walker SAN, Bannerman H, Ma N, et al. - Given the occurrence of delayed diagnosis of bloodstream infection (BSI) in > 20% of older patients, with misdiagnosis in 35%, researchers intended to create as well as validate a clinically beneficial screening instrument to recognize older patients with a high chance of having a BSI. In this retrospective matched case-controlled study, an evaluation of hospitalized patients > 80 years old with BSI (n = 105/group) was performed to develop the tool. For validation, they used distinct retrospectively matched case and control patients > 80 years old (n = 120/group) and 65 to 79 years old (n = 250/group) (test cohort). In the learn and test cohorts, the favorable performance metrics of the optimal screening tool [Ln (odds of BSI) = − 150.299 + 3.751(Tmax: maximum temperature) + 0.654(neutrophils) + 0.452(change in LOC: level of consciousness) + 0.307(BUN: blood urea nitrogen) + 0.154(glucose) + 0.038(albumin) + 0.005(ALT: alanine aminotransferase)] were evident, and this tool outperformed the use of only temperature and neutrophil count. With a high predictive value, the validated tool may afford better early identification as well as treatment of BSI in older patients.
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