158. Adherence to use of blood cultures according to current national guidelines and their impact in patients with community acquired pneumonia: A retrospective cohort
Notice bibliographique
Résumé
Abstract Background Community acquired pneumonia(CAP) is one of the highest infectious causes of mortality. Recommendations about the use of blood cultures in the diagnosis and treatment of CAP has been a continuous topic of debate. Current guidelines specify the situations when blood cultures should be ordered. Methods A retrospective cohort in a teaching hospital in Baltimore USA was conducted that include all the patients that were admitted with diagnosis of CAP as per the International Disease Classification 10 ( ICD 10) between January 1, 2019, and December 31, 2019. Socio demographic and clinical characteristics were obtained, as well as length of hospital stay and mortality. Blood cultures were classified as positive or negative and at the same time it was evaluated if they were done in compliance with current recommendations of Infectious Disease Society of America ( IDSA) Results 721 patients had CAP and were included in the study. Median age was 68 years and almost 50% of the patients were male (n= 293). Most of the patients were from home (84%) and the most common comorbidities were hypertension and diabetes ( 68% and 31 % respectively). 96 patients had positive blood culture and 34% (n= 247) of all the blood cultures were adequately ordered as per current IDSA guidelines. 80 patients died or went to hospice and the median length of stay in our cohort was of 7 days. The multivariate model showed that mortality was associated with positive blood cultures ( OR= 3.1 95%CI 1.63- 5.87)and appropriateness of blood cultures ( OR=2.96 95% CI 1.25.7). Length of hospital stay did not show any association with positive blood cultures, but it was associated with blood culture appropriateness (OR= 1.63 95% CI 1-2.65). Relation bewteen BC and LOS Relationship between appropriateness of BC and length of stay according to the positivity of the BC Multivariate with final disposition Multivariate logistic regression to assess the association with mortality Multivariate length of stay Multivariate logistic regression to assess the association with extended length of stay Conclusion Adequate use of blood cultures in patients with CAP might have some association in the outcomes of patients suffering from this condition. However, a prospective study evaluating the utility of this test following current IDSA recommendations is needed to understand their impact in mortality and morbidity of CAP Disclosures All Authors: No reported disclosures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».