Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital.
Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital.
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DOI：
10.1136/bmjopen-2015-010527
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发表时间：
2016-07-07
期刊：
影响因子：
2.9
通讯作者：
Naito T
中科院分区：
文献类型：
--
作者：
Fukui S;Uehara Y;Fujibayashi K;Takahashi O;Hisaoka T;Naito T
获得血培养的精确标准尚未确定;它们取决于医生的判断。我们检查了临床参数，以确定菌血症的预测因素和普通内科住院患者血培养的需要。回顾性横断面调查。日本一所大学医院。2011年1月1日至2012年12月31日期间进行血培养的所有普通住院患者。从病历中提取血培养采样时或即将采样前的临床信息。使用Fisher精确检验分析可能预测菌血症的因素，然后进行多变量logistic回归模型分析。本研究共纳入200例患者（男性：女性=119：81，年龄64.3±19.1岁）; 57例（28.5%）血培养结果为阳性。多变量logistic回归分析显示，年龄>60岁（OR=2.75，95% CI 1.23至6.48，p=0.015）、女性（OR=2.21，95% CI 1.07至4.67，p=0.038）、脉率>90 bpm（OR=5.18，95% CI 2.25至12.48，p<0.001）和中性粒细胞百分比>80%（OR=3.61，95% CI 1.71至8.00，p=0.001）是血培养结果阳性的独立风险因素。 该模型的受试者工作特征曲线下面积为0.796。我们的研究结果强调了在老年患者和女性患者中，如果脉率>90 bpm，则进行血培养的重要性，以及进行分类白色细胞计数的重要性。
The precise criteria for obtaining blood cultures have not been established; they depend on the physician's judgement. We examined clinical parameters to determine predictive factors of bacteraemia and the need for blood cultures among general medical inpatients. A retrospective cross-sectional survey. A Japanese university hospital. All general inpatients who had blood cultures taken from 1 January 2011 to 31 December 2012. Clinical information at or just before blood culture sampling was extracted from medical charts. Factors potentially predictive of bacteraemia were analysed using Fisher's exact test, followed by multivariable logistic regression model analysis. A total of 200 patients (male: female=119:81, 64.3±19.1 years old) comprised this study; 57 (28.5%) had positive blood culture results. Multivariable logistic regression analysis revealed that age >60 years (OR=2.75, 95% CI 1.23 to 6.48, p=0.015), female sex (OR=2.21, 95% CI 1.07 to 4.67, p=0.038), pulse rate >90 bpm (OR=5.18, 95% CI 2.25 to 12.48, p<0.001) and neutrophil percentage >80% (OR=3.61, 95% CI 1.71 to 8.00, p=0.001) were independent risk factors for positive blood culture results. The area under the receiver operating characteristic curve analysis of this model was 0.796. Our results emphasise the importance of taking blood cultures if the pulse rate is >90 bpm, in elderly patients and in women, and for ordering a differential white cell count.