Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study
Abstract Background Hypervirulent Klebsiella pneumoniae (hvKP) is emerging globally and can cause various, severe infections in healthy individuals. However, the clinical manifestations of hvKP infections are nonspecific, and there is no gold standard for differentiating hvKP strains. Our objective...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08528-x |
| _version_ | 1827724438419800064 |
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| author | Jieen Huang Yanzhu Chen Ming Li Shujin Xie Huasheng Tong Zhusheng Guo Yi Chen |
| author_facet | Jieen Huang Yanzhu Chen Ming Li Shujin Xie Huasheng Tong Zhusheng Guo Yi Chen |
| author_sort | Jieen Huang |
| collection | DOAJ |
| description | Abstract Background Hypervirulent Klebsiella pneumoniae (hvKP) is emerging globally and can cause various, severe infections in healthy individuals. However, the clinical manifestations of hvKP infections are nonspecific, and there is no gold standard for differentiating hvKP strains. Our objective was to develop prognostic models for estimating severity of disease and predicting 30-day all-cause mortality in patients with hvKP infections. Methods We enrolled 116 patients diagnosed with hvKP infections and obtained their demographic and clinical data. Taking septic shock and acute respiratory distress syndrome (ARDS) as the primary outcomes for disease severity and 30-day all-cause mortality as the primary outcome for clinical prognosis, we explored the influencing factors and constructed prognostic models. Results The results showed that increased Acute Physiologic and Chronic Health Evaluation (APACHE) II score [odds ratio (OR) = 1.146; 95% confidence interval (CI), 1.059–1.240], decreased albumin (ALB) level (OR = 0.867; 95% CI, 0.758–0.990), diabetes (OR = 9.591; 95% CI, 1.766–52.075) and high procalcitonin (PCT) level (OR = 1.051; 95%CI, 1.005–1.099) were independent risk factors for septic shock. And increased APACHE II score (OR = 1.254; 95% CI, 1.110–1.147), community-acquired pneumonia (CAP) (OR = 11.880; 95% CI, 2.524–55.923), and extrahepatic lesion involved (OR = 14.718; 95% CI, 1.005–215.502) were independent risk factors for ARDS. Prognostic models were constructed for disease severity with these independent risk factors, and the models were significantly correlated with continuous renal replacement therapy (CRRT) duration, vasopressor duration, mechanical ventilator duration and length of ICU stay. The 30-day all-cause mortality rate in our study was 28.4%. Younger age [hazard ratio (HR) = 0.947; 95% CI, 0.923–0.973)], increased APACHE II score (HR = 1.157; 95% CI, 1.110–1.207), and decreased ALB level (HR = 0.924; 95% CI, 0.869–0.983) were the independent risk factors for 30-day all-cause mortality. A prediction model for 30-day mortality was constructed, which had a good validation effect. Conclusions We developed validated models containing routine clinical parameters for estimating disease severity and predicting 30-day mortality in patients with hvKP infections and confirmed their calibration. The models may assist clinicians in assessing disease severity and estimating the 30-day mortality early. |
| first_indexed | 2024-03-10T22:14:43Z |
| format | Article |
| id | doaj.art-d4fe9fa7e3554d4bb7515eed59c37a9c |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-10T22:14:43Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-d4fe9fa7e3554d4bb7515eed59c37a9c2023-11-19T12:29:21ZengBMCBMC Infectious Diseases1471-23342023-08-0123112010.1186/s12879-023-08528-xPrognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective studyJieen Huang0Yanzhu Chen1Ming Li2Shujin Xie3Huasheng Tong4Zhusheng Guo5Yi Chen6Department of Intensive Care Medicine, Binhaiwan Central Hospital of DongguanDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Laboratory Medicine, Binhaiwan Central Hospital of DongguanDepartment of Laboratory Medicine, Dongguan Tungwah HospitalDepartment of Emergency Medicine, General Hospital of Southern Theatre CommandDepartment of Laboratory Medicine, Dongguan Tungwah HospitalDepartment of Intensive Care Medicine, Binhaiwan Central Hospital of DongguanAbstract Background Hypervirulent Klebsiella pneumoniae (hvKP) is emerging globally and can cause various, severe infections in healthy individuals. However, the clinical manifestations of hvKP infections are nonspecific, and there is no gold standard for differentiating hvKP strains. Our objective was to develop prognostic models for estimating severity of disease and predicting 30-day all-cause mortality in patients with hvKP infections. Methods We enrolled 116 patients diagnosed with hvKP infections and obtained their demographic and clinical data. Taking septic shock and acute respiratory distress syndrome (ARDS) as the primary outcomes for disease severity and 30-day all-cause mortality as the primary outcome for clinical prognosis, we explored the influencing factors and constructed prognostic models. Results The results showed that increased Acute Physiologic and Chronic Health Evaluation (APACHE) II score [odds ratio (OR) = 1.146; 95% confidence interval (CI), 1.059–1.240], decreased albumin (ALB) level (OR = 0.867; 95% CI, 0.758–0.990), diabetes (OR = 9.591; 95% CI, 1.766–52.075) and high procalcitonin (PCT) level (OR = 1.051; 95%CI, 1.005–1.099) were independent risk factors for septic shock. And increased APACHE II score (OR = 1.254; 95% CI, 1.110–1.147), community-acquired pneumonia (CAP) (OR = 11.880; 95% CI, 2.524–55.923), and extrahepatic lesion involved (OR = 14.718; 95% CI, 1.005–215.502) were independent risk factors for ARDS. Prognostic models were constructed for disease severity with these independent risk factors, and the models were significantly correlated with continuous renal replacement therapy (CRRT) duration, vasopressor duration, mechanical ventilator duration and length of ICU stay. The 30-day all-cause mortality rate in our study was 28.4%. Younger age [hazard ratio (HR) = 0.947; 95% CI, 0.923–0.973)], increased APACHE II score (HR = 1.157; 95% CI, 1.110–1.207), and decreased ALB level (HR = 0.924; 95% CI, 0.869–0.983) were the independent risk factors for 30-day all-cause mortality. A prediction model for 30-day mortality was constructed, which had a good validation effect. Conclusions We developed validated models containing routine clinical parameters for estimating disease severity and predicting 30-day mortality in patients with hvKP infections and confirmed their calibration. The models may assist clinicians in assessing disease severity and estimating the 30-day mortality early.https://doi.org/10.1186/s12879-023-08528-xHypervirulent Klebsiella pneumoniaeInfectionsPrognostic modelSeverityMortality |
| spellingShingle | Jieen Huang Yanzhu Chen Ming Li Shujin Xie Huasheng Tong Zhusheng Guo Yi Chen Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study BMC Infectious Diseases Hypervirulent Klebsiella pneumoniae Infections Prognostic model Severity Mortality |
| title | Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study |
| title_full | Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study |
| title_fullStr | Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study |
| title_full_unstemmed | Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study |
| title_short | Prognostic models for estimating severity of disease and predicting 30-day mortality of Hypervirulent Klebsiella pneumoniae infections: a bicentric retrospective study |
| title_sort | prognostic models for estimating severity of disease and predicting 30 day mortality of hypervirulent klebsiella pneumoniae infections a bicentric retrospective study |
| topic | Hypervirulent Klebsiella pneumoniae Infections Prognostic model Severity Mortality |
| url | https://doi.org/10.1186/s12879-023-08528-x |
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