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 ,Revised 5 December 2001 ,Accepted 12 December 2001.

References 

  1. Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk R. Sepsis syndrome (a valid clinical entity. Methylprednisolone Severe Sepsis Study Group). Crit Care Med. 1989;17:389–393
  2. Martı́nez Luengas F, y Grupo colaborador para el estudio de bacteriemias . Bacteriemia en 6 hospitales españoles. Med Clin. 1986;86:221–232
  3. Sota BM, Ezpeleta BC, Cisterna CR. Bacteriemia (estudio multicéntrico con 5000 casos). Rev Clin Esp. 1997;197:3–9
  4. Weinstein MP, Towns ML, Quartey SM, et al.  The clinical significance of positive blood cultures in the 1990s (A prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults). Clin Infect Dis. 1997;24:584–602
  5. Leibovici L, Drucker M, Konigsberger H, et al.  Septic shock in bacteremic patients (risk factors, features and prognosis). Scand J Infect Dis. 1997;29:71–75
  6. Madsen KM, Schonheyder HC, Kristensen B, Sorensen HT. Secular trends in incidence and mortality of bacteraemia in a Danish county 1981–1994. APMIS. 1999;107:346–352
  7. Kochanek KD, Hudson BL. Division of vital statistics (advance report of final mortality statistics, 1992). Month Vital Stat Rep. 1995;43(suppl):
  8. Dirección Xeral de Saúde Pública. Documentos técnicos de Saúde Pública serie B. Numero 8. Consellerı́a de Sanidade e Servicios Sociais. Santiago de Compostela; 1996.
  9. Miller PJ, Wenzel RP. Etiologic organism as independent predictors of death and morbidity associated with bloodstream infections. J Infect Dis. 1987;156:471–477
  10. Kuikka A, Sivonen A, Emelianova A, Valtonen VV. Prognostic factors associated with improved outcome of Escherichia coli bacteremia in a Finnish university hospital. Eur J Microbiol Infect Dis. 1997;16:125–134
  11. Tang E, Tang G, Berne TV. Prognostic indicators in fungemia of the surgical patient. Arch Surg. 1993;128:759–762
  12. Willcox PA, Rayner BL, Whitelaw DA. Community-acquired Staphylococcus aureus bacteraemia in patients who do not abuse intravenous drugs. Q J Med. 1998;91:41–47
  13. Leibovici L, Konisberger H, Pitlik SD, Samra Z, Drucker M. Bacteremia and fungemia of unknown origin in adults. Clin Infect Dis. 1992;14:436–443
  14. Marr KA, Sexton DJ, Conlon PJ, Corey R, Schwab SJ, Kirkland KB. Catheter-related bacteremia and outcome of attemped catheter salvage in patients undergoing hemodialysis. Ann Intern Med. 1997;127:275–280
  15. Meyers BR, Sherman E, Mendelson MH, et al.  Bloodstream infections in the elderly. Am J Med. 1989;86:379–384
  16. Corredoira Sánchez JC, Casariego Vales E, Alonso Garcı́a P, et al.  Bacteriemia en ancianos. Aspectos clı́nicos y factores pronósticos. Med Clin (Barc). 1997;109:165–170
  17. El M, Clarfield AM. Predicting mortality in patients with bacteremia.. J Am Geriatr Soc. 1998;46:1327–1328
  18. Elting LS, Rubenstein EB, Rolston KVI, Bodey GP. Outcomes of bacteremia in patients with cancer and neutropenia (observations from two decades of epidemiological and clinical trials). Clin Infect Dis. 1997;25:247–259
  19. Deulofeu F, Cervelló B, Capell S, Martı́ C, Mercadé V. Predictors of mortality in patients with bacteremia (the importance of functional status). J Am Geriatr Soc. 1998;46:14–18
  20. Leibovici L, Samra Z, Konisberger H, Kalter-Leibovici O, Pitlik SD, Drucker M. Bacteremia in adult diabetic patients. Diabetes Care. 1991;14:89–94
  21. Tumbarello M, Taconelli E, Caponera S, Cauda R, Ortona L. The importance of bacteraemia on HIV infection (nine years experience in a large Italian university hospital). J Infect Dis. 1995;31:123–131
  22. Brun-Bruisson C, Doyon F, Carlet J, for the French Bacteremia-Sepsis Study Group . Bacteremia and severe sepsis in adults (a multicenter prospective survey in ICUs and ward of 24 hospitals). Am J Respir Crit Care Med. 1996;154:617–624
  23. Pittet D, Thiévent B, Wenzel RP, Li N, Auckenthaler R, Suter PM. Bedside prediction of mortality from bacteremic sepsis (a dynamic analysis of ICU patients). Am J Respir Crit Care Med. 1996;153:684–693
  24. Schoenberg MH, Weiss M, Radermacher P. Outcome of patients with sepsis and septic shock after ICU treatment. Langenbecks Arch Surg. 1998;383:44–48
  25. Abraira V, Pérez de Vargas A. Métodos multivariantes en bioestadı́stica. editors. Centro de estudios Ramón Areces S.A. Madrid; 1996.
  26. In:  Lennette EH,  Balows A,  Hausler WJ,  Shadomy HJ editor. Manual of clinical microbiology. 4th ed. Washington, DC: American Society of Microbiology;; 1991;
  27. McCabe WR, Jackson GG. Gram-negative bacteremia. I. Etiology and ecology. Arch Intern Med. 1962;110:845–855
  28. Marubini E, Valsecchi MG. Analysing survival data from clinical trials and observational studies. New York: John Wiley & Sons;; 1995;
  29. Muñoz A, Sunyer J. Comparison of semiparametric and parametric survival models for the analysis of bronchial responsiveness. Am J Respir Crit Care Med. 1996;154:234–239
  30. Altman D, Royston P. What do we mean by validating a prognostic model?. Stat Med. 2000;19:453–473
  31. Marubini E, Bonfanti G, Bozzetti F, et al.  A prognostic score for patients resected for gastric cancer. Eur J Cancer. 1993;29:845–850
  32. Abraira V, Zaplana J. PRESTA: Un paquete de procesamientos estadı́sticos. Resúmenes de la Conferencia Iberoamericana de Bioingenierı́a. Gijón 1984:101.
  33. Statistical and Epidemiology Research Corporation. EGRET User's Manual. Seattle: 1988.
  34. Epstein LD, Muñoz A. A bivariate parametric model for survival and intermediate event times. Stat Med. 1996;15:1171–1185
  35. Dudley RA, Harrell Jr. FE, Smith LR, et al. Comparison of analytic models for estimating the effect of clinical factors on the cost of coronary artery bypass graft surgery. J Clin Epidemiol 1993;46:261–171.
  36. Knaus W, Harrell FE, Fisher CJ, et al.  The clinical evaluation of new drugs for sepsis (a prospective study design based on survival analysis). JAMA. 1993;270:1233–1241
  37. Haug JB, Harthug S, Kalager T, Digranes A, Solberg CO. Bloodstream infections at a Norwegian University Hospital, 1974–1979 and 1988–1989 (changing etiology, clinical features and outcome). Clin Infect Dis. 1994;19:246–256
  38. Weinstein MP, Murphy JR, Reller LB, Lichtenstein KA. The clinical significance of positive blood cultures (a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. II. Clinical observations with special reference to factors influencing prognosis). Rev Infect Dis. 1983;5:54–70
  39. Bryan CS, Hornung CA, Reynolds KL, Brenner ER. Endemic bacteremia in Columbia, South Carolina. Am J Epidemiol. 1986;123:113–127
  40. Roberts FJ, Geere IW, Coldman . A three-year study of positive blood cultures, with emphasis on prognosis. Rev Infect Dis. 1991;13:34–46
  41. Ispahani P, Pearson NJ, Greenwood D. An analysis of community and hospital-acquired bacteremia in a large teaching hospital in the United Kingdom. Q J Med. 1987;63:427–440
  42. Leibovici L, Drucker M, Samra Z, Konisberger H, Pitlik SD. Prognostic significance of the neutrophil count in immunocompetent patients with bacteremia. Q J Med. 1995;88:181–189
  43. Grandsen WR, Eykyn SJ, Phillips I, Rowe B. Bacteremia due to Escherichia coli (a study of 861 episodes). Rev Infect Dis. 1990;12:1008–1018
  44. Galofré J, Moreno A, Mensa J, et al.  Analysis of factors influencing the outcome and development of septic metastasis or relapse in salmonella bacteremia. Clin Infect Dis. 1994;18:873–878
  45. Chow JW, Fine MJ, Shlaes DM, et al.  Enterobacter bacteremia (clinical features and emergence of antibiotic resistance during therapy). Ann Intern Med. 1991;115:585–590
  46. Martin MA, Pfaller MA, Wenzel RP. Coagulase-negative staphylococcal bacteremia (mortality and hospital stay). Ann Intern Med. 1989;110:9–16
  47. Maradona JA, Alvarez MA, Cartón JA, Arribas JM. Bacteriemia quirúrgica. Análisis de 210 episodios con especial atención a los factores que influyen en el pronóstico. Enferm Infecc Microbiol Clin. 1992;10:14–20
  48. Leibovici L, Samra Z, Konigsberger H, Drucker M, Ashkenazi S, Pitlik SD. Long-term survival following bacteremia or fungemia. JAMA. 1995;274:807–812
  49. Quartin AA, Schein RMH, Kett DH, Peduzzi PN. Magnitude and duration of the effect of sepsis on survival. JAMA. 1997;277:1058–1063
  50. The Veterans Administration Systemic Sepsis Cooperative Study Group . Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis.. N Engl J Med. 1987;317:659–665
  51. Bollaert PE, Charpentier C, Levy B, Debouverie M, Audibert G, Larcan A. Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med. 1998;26:645–650
  52. Ziegler EJ, Fisher CJ, Sprung CL, et al.  Treatment of gram-negative bacteremia and shock septic with HA-1A human monoclonal antibody against endotoxin (a randomized, double-bind, placebo controlled trial: the HA-1A Sepsis Study Group). N Engl J Med. 1991;324:429–436
  53. Bates DW, Pruess KE, Lee TH. How bad are bacteremia and sepsis? Outcomes in a cohort with suspected bacteremia. Arch Intern Med. 1995;155:593–598
  54. Bates DW, Cook F, Goldman L, Lee TH. Predicting bacteremia in hospitalized patients; a prospectively validated model. Ann Intern Med. 1990;113:495–500
  55. Ac J, Covinsky KE, Berlin JE. Assessing the generalizability of prognostic information. Ann Intern Med. 1999;130:515–524
  56. Wasson JH, Sox HC, Neff RK, Goldman L. Clinical prediction rules (applications and methodological standards). N Engl J Med. 1985;313:793–799

PII: S0895-4356(01)00520-0

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

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