Journal of Clinical Epidemiology
Volume 55, Issue 6 , Pages 563-572, June 2002

A predictive model for mortality of bloodstream infections:

Bedside analysis with the Weibull function

  • Emilio Casariego Vales

      Affiliations

    • Department of Internal Medicine, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
    • Corresponding Author InformationCorresponding author. Ronda de la Muralla, 81-82, 6D 27003 Lugo, Spain. Tel.: +34-982-251035; fax: +34-982-296271.(E.C. Vales)
  • ,
  • Victor Abraira

      Affiliations

    • Biostatistics Unit, Hospital Ramón y Cajal, Crta. de Colmenar, Km. 9,100, 28034 Madrid, Spain
  • ,
  • Juan Carlos Corredoira Sánchez

      Affiliations

    • Department of Internal Medicine, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • Marı́a Pilar Alonso Garcı́a

      Affiliations

    • Microbiology Unit, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • Asunción Rodrı́guez Feijoo

      Affiliations

    • Microbiology Unit, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • Marı́a José López Alvarez

      Affiliations

    • Department of Internal Medicine, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • José Varela Otero

      Affiliations

    • Department of Internal Medicine, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • Amparo Coira Nieto

      Affiliations

    • Microbiology Unit, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • Ramón Rabuñal Rey

      Affiliations

    • Department of Internal Medicine, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain
  • ,
  • Marı́a Teresa Rigueiro Veloso

      Affiliations

    • Department of Internal Medicine, Hospital Xeral-Calde, C/ Severo Ochoa, s/n. 27004, Lugo, Spain

Received 29 October 1999; received in revised form 5 December 2001; accepted 12 December 2001.

Abstract 

This paper describes the construction and validation of a prognostic model for predicting post-bloodstream infection survival up to Day 21. A Weibull multiple regression model was adopted in a prospective cohort study of all patients diagnosed with true bacteremia or fungemia in a teaching hospital between 1991 and 1994 (training set, 1,577 patients). The final model included six variables easily detected in any institution: source of infection, underlying neoplasm, septic shock, community-acquired, age over 65, and polymicrobial bacteremia. Using this model, it is possible to obtain a graphic representation of survival probability for any combination of these risk factors. The model was tested on a second set of patients diagnosed in the same hospital between 1996 and 1997 (validation set, 952 patients), confirming its reliability in predicting survival. In conclusion, the Weibull function, together with variables easily identified at bedside, enables a precise prediction of the short-term, post-bloodstream infection mortality of a given patient.

Keywords:  Bloodstream infection, Septicemia, Survival analysis, Mortality, Prognosis, Weibull function

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PII: S0895-4356(01)00520-0

Journal of Clinical Epidemiology
Volume 55, Issue 6 , Pages 563-572, June 2002