Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics
Abstract Background The development of scoring systems to predict the short-term mortality and the length of hospital stay (LOS) in patients with bacteraemia is essential to improve the quality of care and reduce the occupancy variance in the hospital bed. Methods Adults hospitalised with community-...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08547-8 |
| _version_ | 1827724311904911360 |
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| author | Ching-Chi Lee Yuan-Pin Hung Chih-Chia Hsieh Ching-Yu Ho Chiao-Ya Hsu Cheng-Te Li Wen-Chien Ko |
| author_facet | Ching-Chi Lee Yuan-Pin Hung Chih-Chia Hsieh Ching-Yu Ho Chiao-Ya Hsu Cheng-Te Li Wen-Chien Ko |
| author_sort | Ching-Chi Lee |
| collection | DOAJ |
| description | Abstract Background The development of scoring systems to predict the short-term mortality and the length of hospital stay (LOS) in patients with bacteraemia is essential to improve the quality of care and reduce the occupancy variance in the hospital bed. Methods Adults hospitalised with community-onset bacteraemia in the coronavirus disease 2019 (COVID-19) and pre-COVID-19 eras were captured as the validation and derivation cohorts in the multicentre study, respectively. Model I incorporated all variables available on day 0, Model II incorporated all variables available on day 3, and Models III, IV, and V incorporated the variables that changed from day 0 to day 3. This study adopted the statistical and machine learning (ML) methods to jointly determine the prediction performance of these models in two study cohorts. Results A total of 3,639 (81.4%) and 834 (18.6%) patients were included in the derivation and validation cohorts, respectively. Model IV achieved the best performance in predicting 30-day mortality in both cohorts. The most frequently identified variables incorporated into Model IV were deteriorated consciousness from day 0 to day 3 and deteriorated respiration from day 0 to day 3. Model V achieved the best performance in predicting LOS in both cohorts. The most frequently identified variables in Model V were deteriorated consciousness from day 0 to day 3, a body temperature ≤ 36.0 °C or ≥ 39.0 °C on day 3, and a diagnosis of complicated bacteraemia. Conclusions For hospitalised adults with community-onset bacteraemia, clinical variables that dynamically changed from day 0 to day 3 were crucial in predicting the short-term mortality and LOS. |
| first_indexed | 2024-03-10T22:14:00Z |
| format | Article |
| id | doaj.art-16a53ab53cc34d1a9bcd5f648187093a |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-10T22:14:00Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-16a53ab53cc34d1a9bcd5f648187093a2023-11-19T12:29:24ZengBMCBMC Infectious Diseases1471-23342023-09-0123111210.1186/s12879-023-08547-8Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamicsChing-Chi Lee0Yuan-Pin Hung1Chih-Chia Hsieh2Ching-Yu Ho3Chiao-Ya Hsu4Cheng-Te Li5Wen-Chien Ko6Clinical Medical Research Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityDepartment of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityDepartment of Medicine, College of Medicine, National Cheng Kung UniversityDepartment of Adult Critical Care Medicine, Tainan Sin-Lau HospitalInstitute of Data Science, National Cheng Kung UniversityInstitute of Data Science, National Cheng Kung UniversityDepartment of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityAbstract Background The development of scoring systems to predict the short-term mortality and the length of hospital stay (LOS) in patients with bacteraemia is essential to improve the quality of care and reduce the occupancy variance in the hospital bed. Methods Adults hospitalised with community-onset bacteraemia in the coronavirus disease 2019 (COVID-19) and pre-COVID-19 eras were captured as the validation and derivation cohorts in the multicentre study, respectively. Model I incorporated all variables available on day 0, Model II incorporated all variables available on day 3, and Models III, IV, and V incorporated the variables that changed from day 0 to day 3. This study adopted the statistical and machine learning (ML) methods to jointly determine the prediction performance of these models in two study cohorts. Results A total of 3,639 (81.4%) and 834 (18.6%) patients were included in the derivation and validation cohorts, respectively. Model IV achieved the best performance in predicting 30-day mortality in both cohorts. The most frequently identified variables incorporated into Model IV were deteriorated consciousness from day 0 to day 3 and deteriorated respiration from day 0 to day 3. Model V achieved the best performance in predicting LOS in both cohorts. The most frequently identified variables in Model V were deteriorated consciousness from day 0 to day 3, a body temperature ≤ 36.0 °C or ≥ 39.0 °C on day 3, and a diagnosis of complicated bacteraemia. Conclusions For hospitalised adults with community-onset bacteraemia, clinical variables that dynamically changed from day 0 to day 3 were crucial in predicting the short-term mortality and LOS.https://doi.org/10.1186/s12879-023-08547-8Prediction modelCommunity-onsetBloodstream infectionsLength of hospital stayMortalityCOVID-19 |
| spellingShingle | Ching-Chi Lee Yuan-Pin Hung Chih-Chia Hsieh Ching-Yu Ho Chiao-Ya Hsu Cheng-Te Li Wen-Chien Ko Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics BMC Infectious Diseases Prediction model Community-onset Bloodstream infections Length of hospital stay Mortality COVID-19 |
| title | Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics |
| title_full | Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics |
| title_fullStr | Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics |
| title_full_unstemmed | Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics |
| title_short | Predictive models for short-term mortality and length of hospital stay among adults with community-onset bacteraemia before and during the COVID-19 pandemic: application of early data dynamics |
| title_sort | predictive models for short term mortality and length of hospital stay among adults with community onset bacteraemia before and during the covid 19 pandemic application of early data dynamics |
| topic | Prediction model Community-onset Bloodstream infections Length of hospital stay Mortality COVID-19 |
| url | https://doi.org/10.1186/s12879-023-08547-8 |
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