Patient selection: cardiothoracic surgery patient in the ICU. Exclusion includes immunodeficieincy
Outcomes: candidemia and candidemia-related deaths
Parameters prior to onset of candidemia:
(1) duration of invasive mechanical ventilation (IMV) in days
(2) hospital-acquired bacterial infection including bacteremia requiring administration of 2 or more broad-spectrum antibiotics
(3) duration of cardiopulmonary bypass in minutes
(4) diabetes mellitus
|
Parameters
|
Findings
|
Points
|
|
duration of IMV
|
< 10 days
|
0
|
|
|
>= 10 days
|
1
|
|
HAI
|
absent
|
0
|
|
|
present
|
1
|
|
duration of cardiopulmonary bypass
|
<= 120 minutes
|
0
|
|
|
> 120 minutes
|
1
|
|
diabetes mellitus
|
absent
|
0
|
|
|
present
|
1
|
total number of risk factors for Candidemia =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The risk for candidemia increases as the number of risk factors increase.
• For a patient with candidemia, an APACHE II score >= 30 at the onset of candidemia was associated with candidemia-related mortality.
• Duration of IMV and HAI were the 2 most important findings.
