Enterococcal bloodstream infection. Design and validation of a mortality prediction rule

Abstract

Background: To develop a prediction rule to describe the risk of death as a result of enterococcal bloodstream infection. Methods: A prediction rule was

developed by analysing data collected from 122 patients diagnosed with entero- coccal BSI admitted to the Clınica Universidad de Navarra (Pamplona, Spain); and

validated by confirming its accuracy with the data of an external population

(Hospital del Mar, Barcelona). Results: According to this model, independent sig- nificant predictors for the risk of death were being diabetic, have received appro- priate treatment, severe prognosis of the underlying diseases, have renal failure,

received solid organ transplant, malignancy, source of the bloodstream infection and be immunosuppressed. The prediction rule showed a very good calibration (Hosmer–Lemeshow statistic, P = 0.93) and discrimination for both training and testing sets (area under ROC curve = 0.84 and 0.83 respectively). Conclusions: The predictive rule was able to predict risk of death as a result of enterococcal

bloodstream infection as well as to identify patients, who being below the thresh- old value, will have a low risk of death with a negative predictive value of 96%.