158. Adherence to use of blood cultures according to current national guidelines and their impact in patients with community acquired pneumonia: A retrospective cohort
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".