[Usefulness of the MPB-INFURG-SEMES model to predict bacteremia in the patient with solid tumor in the Emergency Department].

M Muelas González, E Torner Marchesi, G Peláez Díaz, M Ramos Aranguez, J Cabañas Morafraile, W López Forero, R Rubio Díaz, J González Del Castillo, F J Candel, A Julián-Jiménez
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Abstract

Objective: To analyse a new risk score to predict bacteremia (MPB-INFURG-SEMES) in the patients with solid tumor attender for infection in the emergency departments (ED).

Methods: Prospective, multicenter observational cohort study of blood cultures (BC) obtained from adult patients with solid neoplasia treated in 63 EDs for infection 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 857 blood samples wered cultured. True cases of bacteremia were confirmed in 196 (22.9%). The remaining 661 cultures (77.1%) wered negative. And, 42 (4.9%) were judged to be contaminated. The model's area under the receiver operating characteristic curve was 0.923 (95% CI,0.896-0.950). The prognostic performance with a model's cut-off value of ≥ 5 points achieved 95.74% (95% CI, 94,92-96.56) sensitivity, 76.06% (95% CI, 75.24-76.88) specificity, 53.42%(95% CI, 52.60-54.24) positive predictive value and 98.48% (95% CI, 97.66- 99.30) negative predictive value.

Conclusions: The MPB-INFURG-SEMES score is useful for predicting bacteremia in the adults patients with solid tumor seen in the ED.

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[MPB-INFURG-SEMES模型在预测急诊科实体瘤患者菌血症方面的实用性]。
目的分析预测急诊科(ED)实体瘤患者感染菌血症的新风险评分(MPB-INFURG-SEMES):方法:对2019年11月1日至2020年3月31日期间在63个急诊科接受感染治疗的实体瘤成人患者进行血液培养(BC)的前瞻性、多中心观察性队列研究。该模型的预测能力通过接收者操作特征曲线下面积(AUC-ROC)进行分析。根据所选的临界值计算出真实菌血症的预后性能,从而得出灵敏度、特异性、阳性预测值和阴性预测值:结果:共培养了 857 份血液样本。有 196 例(22.9%)确诊为菌血症。其余 661 份(77.1%)培养结果为阴性。42份(4.9%)被判定为污染。该模型的接收者操作特征曲线下面积为 0.923(95% CI,0.896-0.950)。模型临界值≥5点的预后性能达到了95.74%(95% CI,94,92-96.56)的灵敏度、76.06%(95% CI,75.24-76.88)的特异性、53.42%(95% CI,52.60-54.24)的阳性预测值和98.48%(95% CI,97.66-99.30)的阴性预测值:MPB-INFURG-SEMES评分可用于预测急诊科实体瘤成人患者的菌血症。
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