Predicting mortality in intensive care unit patients infected with Klebsiella pneumoniae: A retrospective cohort study

被引:3
|
作者
Tran, Thuy Ngan [1 ]
Dinh Hoa Vu [2 ]
Hoang Anh Nguyen [2 ,6 ]
Abrams, Steven [1 ,3 ]
Bruyndonckx, Robin [3 ,4 ]
Thi Tuyen Nguyen [2 ]
Nhat Minh Tran [2 ]
The Anh Trinh [5 ]
Thi Hong Gam Do [6 ]
Hong Nhung Pham [7 ]
Gia Binh Nguyen [5 ]
Coenen, Samuel [1 ,4 ]
机构
[1] Univ Antwerp, Dept Family Med & Populat Hlth FAMPOP, Antwerp, Belgium
[2] Hanoi Univ Pharm, Natl Ctr Drug Informat & Adverse Drug React Monit, Hanoi, Vietnam
[3] Hasselt Univ, Data Sci Inst DSI, Interuniv Inst Biostat & Stat Bioinformat I BIOST, Hasselt, Belgium
[4] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Antwerp, Belgium
[5] Bach Mai Hosp, Intens Care Unit, Hanoi, Vietnam
[6] Bach Mai Hosp, Dept Pharm, Hanoi, Vietnam
[7] Bach Mai Hosp, Dept Microbiol, Hanoi, Vietnam
关键词
Klebsiella pneumoniae; Intensive care unit; Mortality; Prediction; Prognosis; BLOOD-STREAM INFECTIONS; RISK-FACTORS; SOFA SCORE; CARBAPENEM; OUTCOMES; REGRESSION; THERAPY; IMPACT;
D O I
10.1016/j.jiac.2021.09.001
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Introduction: Although several models to predict intensive care unit (ICU) mortality are available, their perfor-mance decreases in certain subpopulations because specific factors are not included. Moreover, these models often involve complex techniques and are not applicable in low-resource settings. We developed a prediction model and simplified risk score to predict 14-day mortality in ICU patients infected with Klebsiella pneumoniae. Methodology: A retrospective cohort study was conducted using data of ICU patients infected with Klebsiella pneumoniae at the largest tertiary hospital in Northern Vietnam during 2016-2018. Logistic regression was used to develop our prediction model. Model performance was assessed by calibration (area under the receiver operating characteristic curve-AUC) and discrimination (Hosmer-Lemeshow goodness-of-fit test). A simplified risk score was also constructed. Results: Two hundred forty-nine patients were included, with an overall 14-day mortality of 28.9%. The final prediction model comprised six predictors: age, referral route, SOFA score, central venous catheter, intracerebral haemorrhage surgery and absence of adjunctive therapy. The model showed high predictive accuracy (AUC = 0.83; p-value Hosmer-Lemeshow test = 0.92). The risk score has a range of 0-12 corresponding to mortality risk 0-100%, which produced similar predictive performance as the original model. Conclusions: The developed prediction model and risk score provide an objective quantitative estimation of individual 14-day mortality in ICU patients infected with Klebsiella pneumoniae. The tool is highly applicable in practice to help facilitate patient stratification and management, evaluation of further interventions and allo-cation of resources and care, especially in low-resource settings where electronic systems to support complex models are missing.
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页码:10 / 18
页数:9
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