Pitt bacteremia score: Difference between revisions
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* Originally developed to predict mortality with [[Pseudomonas aeruginosa]] [[bacteremia]] |
* Originally developed to predict mortality with [[Pseudomonas aeruginosa]] [[bacteremia]] |
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* Now used more broadly for mortality from infections more generally |
* Now used more broadly for mortality from infections more generally |
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* A modified Pitt bacteremia score (mPBS) also exists[[CiteRef::nakada‐motokawa2021mo]] |
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== Components == |
== Components == |
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{| class="wikitable" |
{| class="wikitable" |
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!Criterion |
!Criterion |
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!Points |
!Points (original) |
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!Points (modified) |
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|- |
|- |
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| colspan=" |
| colspan="3" |Fever (°C) |
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|- |
|- |
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|≤35 or ≥40 |
| ≤35 or ≥40 |
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|2 |
|2 |
||
| ⚫ | |||
|- |
|- |
||
|35.1-36.0 or 39.0-39.9 |
| 35.1-36.0 or 39.0-39.9 |
||
|1 |
|1 |
||
| ⚫ | |||
|- |
|- |
||
|36.1-38.9 |
| 36.1-38.9 |
||
|0 |
|0 |
||
| ⚫ | |||
|- |
|- |
||
|Hypotension: drop by >30 SBP or >20 DBP, or vasopressors, or SBP <90 |
|Hypotension: drop by >30 SBP or >20 DBP, or vasopressors, or SBP <90 |
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| ⚫ | |||
|2 |
|2 |
||
|- |
|- |
||
|Mechanical ventilation |
|Mechanical ventilation |
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| ⚫ | |||
|2 |
|2 |
||
|- |
|- |
||
|Cardiac arrest |
|Cardiac arrest |
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| ⚫ | |||
|4 |
|4 |
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|- |
|- |
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| colspan=" |
| colspan="3" |Mental status |
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|- |
|- |
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| Alert |
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|Alert |
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| ⚫ | |||
|0 |
|0 |
||
|- |
|- |
||
|Disoriented |
| Disoriented |
||
| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
| Stuporous/comatose |
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| ⚫ | |||
|2 |
|2 |
||
|- |
|- |
||
| Comatose |
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|Suporous/comatose |
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|4 |
|4 |
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| ⚫ | |||
| ⚫ | |||
|Dialysis |
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| |
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|2 |
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|} |
|} |
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|+Mortality predicted by PBS for various infections. |
|+Mortality predicted by PBS for various infections. |
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!Score |
!Score |
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!Gram-negative bacteremia (28-day mortality)[[CiteRef::al-hasan2013pr]] |
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![[Staphylococcus aureus bacteremia|SAB]] (30-dy mortality)<ref>Roth JA, Tschudin-Sutter S, Dangel M, Frei R, Battegay M, Widmer AF. Value of the Pitt Bacteraemia Score to predict short-term mortality in Staphylococcus aureus bloodstream infection: a validation study. Swiss Med Wkly [Internet]. 2017 Aug. 10 [cited 2023 Feb. 8];147(3132):w14482. Available from: https://smw.ch/index.php/smw/article/view/2342</ref> |
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![[Staphylococcus aureus bacteremia|SAB]] (30-day mortality)[[CiteRef::10.4414/smw.2017.14482]] |
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!Nonbacteremic infections (14-day mortality)<ref>Heather Henderson, Courtney L Luterbach, Eric Cober, Sandra S Richter, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Yohei Doi, Keith S Kaye, Scott Evans, Vance G Fowler, Jr, Robert A Bonomo, Anthony Harris, Sonia Napravnik, David Van Duin, The Pitt Bacteremia Score Predicts Mortality in Nonbacteremic Infections, ''Clinical Infectious Diseases'', Volume 70, Issue 9, 1 May 2020, Pages 1826–1833, https://doi.org/10.1093/cid/ciz528</ref> |
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!Nonbacteremic infections (14-day mortality)[[CiteRef::henderson2019th]] |
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!Candidemia (mPBS) (30-day mortality)[[CiteRef::nakada‐motokawa2021mo]] |
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|- |
|- |
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|0 |
|0 |
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|≤1% |
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|8% |
|8% |
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| rowspan="4" |5% |
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| ⚫ | |||
| rowspan="4" |14% |
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|- |
|- |
||
|1 |
|1 |
||
| ⚫ | |||
|5% |
|5% |
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| ⚫ | |||
|- |
|- |
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|2 |
|2 |
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|1.5% |
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|15% |
|15% |
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| ⚫ | |||
|- |
|- |
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|3 |
|3 |
||
| |
|2% |
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| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
|≥4 |
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| ⚫ | |||
|40% |
|40% |
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|- |
|- |
||
|4 |
|4 |
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|3% |
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|47% |
|47% |
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| rowspan="7" |40% |
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| ⚫ | |||
| rowspan="4" |37% |
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|- |
|- |
||
|5 |
|5 |
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|5% |
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|33% |
|33% |
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| ⚫ | |||
|- |
|- |
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|6 |
|6 |
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|7% |
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|43% |
|43% |
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| ⚫ | |||
|- |
|- |
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|7 |
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|≥7 |
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| |
|10% |
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| rowspan="4" |75% |
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| ⚫ | |||
|- |
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|8 |
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|14% |
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| rowspan="3" |69% |
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|- |
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|9 |
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|20% |
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|- |
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|≥10 |
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|27-81% |
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|} |
|} |
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[[Category:Infectious diseases]] |
[[Category:Infectious diseases]] |
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Latest revision as of 17:22, 27 September 2024
Background
- Originally developed to predict mortality with Pseudomonas aeruginosa bacteremia
- Now used more broadly for mortality from infections more generally
- A modified Pitt bacteremia score (mPBS) also exists1
Components
- Measured at onset of bacteremia
| Criterion | Points (original) | Points (modified) |
|---|---|---|
| Fever (°C) | ||
| ≤35 or ≥40 | 2 | |
| 35.1-36.0 or 39.0-39.9 | 1 | |
| 36.1-38.9 | 0 | |
| Hypotension: drop by >30 SBP or >20 DBP, or vasopressors, or SBP <90 | 2 | 2 |
| Mechanical ventilation | 2 | 2 |
| Cardiac arrest | 4 | 4 |
| Mental status | ||
| Alert | 0 | 0 |
| Disoriented | 1 | 1 |
| Stuporous/comatose | 2 | 2 |
| Comatose | 4 | 4 |
| Dialysis | 2 | |
Interpretation
- ≥4 usually used as a cutoff for increased risk of death
| Score | Gram-negative bacteremia (28-day mortality)2 | SAB (30-day mortality)3 | Nonbacteremic infections (14-day mortality)4 | Candidemia (mPBS) (30-day mortality)1 |
|---|---|---|---|---|
| 0 | ≤1% | 8% | 5% | 14% |
| 1 | 1% | 5% | ||
| 2 | 1.5% | 15% | ||
| 3 | 2% | 40% | ||
| 4 | 3% | 47% | 40% | 37% |
| 5 | 5% | 33% | ||
| 6 | 7% | 43% | ||
| 7 | 10% | 75% | ||
| 8 | 14% | 69% | ||
| 9 | 20% | |||
| ≥10 | 27-81% |
References
- a b Nana Nakada‐Motokawa, Taiga Miyazaki, Takashi Ueda, Yuka Yamagishi, Koichi Yamada, Hideki Kawamura, Hiroshi Kakeya, Hiroshi Mukae, Hiroshige Mikamo, Yoshio Takesue, Shigeru Kohno. Modified Pitt bacteremia score for predicting mortality in patients with candidaemia: A multicentre seven‐year retrospective study conducted in Japan. Mycoses. 2021;64(12):1498-1507. doi:10.1111/myc.13380.
- ^ M.N. Al-Hasan, B.D. Lahr, J.E. Eckel-Passow, L.M. Baddour. Predictive scoring model of mortality in Gram-negative bloodstream infection. Clinical Microbiology and Infection. 2013;19(10):948-954. doi:10.1111/1469-0691.12085.
- ^ 10.4414/smw.2017.14482
- ^ Heather Henderson, Courtney L Luterbach, Eric Cober, Sandra S Richter, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Yohei Doi, Keith S Kaye, Scott Evans, Vance G Fowler, Robert A Bonomo, Anthony Harris, Sonia Napravnik, David Van Duin. The Pitt Bacteremia Score Predicts Mortality in Nonbacteremic Infections. Clinical Infectious Diseases. 2019;70(9):1826-1833. doi:10.1093/cid/ciz528.
