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Prediction Rule for Bacteremia in Patient with Community Acquired Pneumonia

Purpose: To identify a patient with community-acquired pneumonia who is at increased risk for bacteremia using the prediction rule of Falguera et al.

Description

Falguera et al developed a score for helping to identify a patient with community acquired pneumonia (CAP) who is at risk for developing bacteremia. This can help to identify a patient who may benefit from more aggressive management. The authors are from the NAC-CALIDAD (Proyecto Integrado de Investigacion de la Sociedad Espanola de Patologie del Aparato Respiratorio sobre Infecciones Respiratorieas de Visas Bajas) Study Group in Spain.


 

Parameters:

(1) prior antibiotic use

(2) chronic liver disease

(3) pleuritic pain

(4) heart rate in beats per minute

(5) respiratory rate in breaths per minute

(6) systolic blood pressure in mm Hg

 

Parameter

Finding

Points

prior antibiotic use

absent

1

 

present

0

chronic liver disease

absent

0

 

present

1

pleuritic pain

absent

0

 

present

1

heart rate

<= 125 beats per minute

0

 

> 125 beats per minute (tachycardia)

1

respiratory rate

<= 30 breaths per minute

0

 

> 30 breaths per minute (techypnea)

1

systolic blood pressure

>= 90 mm Hg

0

 

< 90 mm Hg (hypotensive)

1

 

total score =

= SUM(points for all 6 paramters)

 

Interpretation:

• minimum score: 0

• maximum score: 6

• The higher the score the greater the risk of bacteremia.

• A score >= 2 was used to identify the patients at risk for bacteremia. This group had positive blood cultures in 14-63% of patients; patients with a score <= 1 had rate of < 8%.

 

Performance:

• The diagnostic accuracy was 69%.

 


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Specialty

Objective

ICD-10