|
Overview :
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
|