Bates et al developed a scoring system to identify those hospitalized patients at risk for having bacteremia based on historical and clinical findings.
Study population: Patients at Brigham and Women's Hospital in Boston in 1988 and 1989.
Parameters used for scoring:
(1) maximum body temperature
(2) life expectancy based on underlying disease
(3) chills
(4) history of intravenous drug abuse
(5) acute abdomen on physical examination
(6) presence of one or more major comorbidities
|
Parameter |
Finding |
Points |
|---|---|---|
|
maximum temperature |
>= 38.3°C |
3 |
|
|
< 38.3°C |
0 |
|
underlying disease |
rapidly fatal (< 1 month) |
4 |
|
|
ultimately fatal (>= 1 month to < 5 years) |
2 |
|
|
other |
0 |
|
chills |
present |
3 |
|
|
absent |
0 |
|
intravenous drug abuse |
present |
4 |
|
|
absent |
0 |
|
acute abdomen on examination |
present |
3 |
|
|
absent |
0 |
|
major comorbidity |
present |
3 |
|
|
absent |
0 |
Acute abdomen on physical examination - one or more of the following:
(1) rebound tenderness
(2) guarding
(3) moderate to severe tenderness
Major comorbidity - one or more of the following:
(1) coma or brain death
(2) bowel perforation
(3) multiple trauma
(4) burns
(5) cardiopulmonary arrest within 24 hours
(6) cardiac transplantation
(7) bone marrow transplantation
(8) severe pancreatitis
(9) acute respiratory distress syndrome
(10) hepatic failure
risk score =
= SUM(points for findings present)
Interpretation:
• minimum score: 0
• maximum score: 20
|
Risk Score |
Percent Bacteremia |
Risk Group |
|---|---|---|
|
0 - 2 |
1-2% |
low |
|
3 |
5-7% |
intermediate |
|
4 - 5 |
9-10% |
intermediate-to-high |
|
>= 6 |
14-16% |
high |
based on combining derivation and validation sets in Table 5, page 499
Purpose: To use a score to predict the risk of bacteremia in a hospitalized patient based on history and clinical findings.
Specialty: Infectious Diseases
Objective: risk factors, severity, prognosis, stage
ICD-10: A49.9,
