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]]
 
* Now used more broadly for mortality from infections more generally
  
* Now used more broadly for mortality from infections more generally
  +
* A modified Pitt bacteremia score (mPBS) also exists<ref name=":0">Nakada-Motokawa, N, Miyazaki, T, Ueda, T, et al. Modified Pitt bacteremia score for predicting mortality in patients with candidaemia: A multicentre seven-year retrospective study conducted in Japan. ''Mycoses''. 2021; 64: 1498-1507. https://doi.org/10.1111/myc.13380</ref>
   
 
== Components ==
  
== Components ==
Line 10: Line 11:
 
{| class="wikitable"
  
{| class="wikitable"
 
!Criterion
  
!Criterion
−
!Points
 +
!Points (original)
  +
!Points (modified)
 
|-
  
|-
−
| colspan="2" |Fever (°C)
 +
| colspan="3" |Fever (°C)
 
|-
  
|-
−
|≤35 or ≥40
 +
|&nbsp;&nbsp;&nbsp;&nbsp;≤35 or ≥40
 
|2
  
|2
  ⚫
|
 
|-
  
|-
−
|35.1-36.0 or 39.0-39.9
 +
|&nbsp;&nbsp;&nbsp;&nbsp;35.1-36.0 or 39.0-39.9
 
|1
  
|1
  ⚫
|
 
|-
  
|-
−
|36.1-38.9
 +
|&nbsp;&nbsp;&nbsp;&nbsp;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
  ⚫
|2
 
|2
  
|2
 
|-
  
|-
 
|Mechanical ventilation
  
|Mechanical ventilation
  ⚫
|2
 
|2
  
|2
 
|-
  
|-
 
|Cardiac arrest
  
|Cardiac arrest
  ⚫
|4
 
|4
  
|4
 
|-
  
|-
−
| colspan="2" |Mental status
 +
| colspan="3" |Mental status
 
|-
  
|-
  +
|&nbsp;&nbsp;&nbsp;&nbsp;Alert
−
|Alert
  
  ⚫
|0
 
|0
  
|0
 
|-
  
|-
−
|Disoriented
 +
|&nbsp;&nbsp;&nbsp;&nbsp;Disoriented
  ⚫
|1
  ⚫
|1
  ⚫
|-
  +
|&nbsp;&nbsp;&nbsp;&nbsp;Stuporous/comatose
  ⚫
|2
 
|2
  
|2
 
|-
  
|-
  +
|&nbsp;&nbsp;&nbsp;&nbsp;Comatose
−
|Suporous/comatose
  
 
|4
  
|4
  ⚫
|4
  ⚫
|-
  +
|Dialysis
  +
|
  +
|2
 
|}
  
|}
   
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|+Mortality predicted by PBS for various infections.
  
|+Mortality predicted by PBS for various infections.
 
!Score
  
!Score
−
![[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>
 +
!Gram-negative bacteremia (28-day mortality)<ref>Al-Hasan MN, Lahr BD, Eckel-Passow JE, Baddour LM. Predictive scoring model of mortality in Gram-negative bloodstream infection. Clin Microbiol Infect. 2013 Oct;19(10):948-54. doi: [https://doi.org/10.1111/1469-0691.12085 10.1111/1469-0691.12085]. Epub 2012 Nov 27. PMID: [https://pubmed.ncbi.nlm.nih.gov/23190091/ 23190091].</ref>
  +
![[Staphylococcus aureus bacteremia|SAB]] (30-day 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>
 
!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>
  
!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>
  +
!Candidemia (mPBS) (30-day mortality)<ref name=":0" />
 
|-
  
|-
 
|0
  
|0
  +
|≤1%
 
|8%
  
|8%
  +
| rowspan="4" |5%
⚫
|
  
  +
| rowspan="4" |14%
 
|-
  
|-
 
|1
  
|1
  ⚫
|1%
 
|5%
  
|5%
⚫
|
  
 
|-
  
|-
 
|2
  
|2
  +
|1.5%
 
|15%
  
|15%
⚫
|
  
 
|-
  
|-
 
|3
  
|3
−
|40%
 +
|2%
⚫
|
  
⚫
|-
  
⚫
|<4
  
⚫
|
  
⚫
|5%
  
⚫
|-
  
−
|≥4
  
⚫
|
  
 
|40%
  
|40%
 
|-
  
|-
 
|4
  
|4
  +
|3%
 
|47%
  
|47%
  +
| rowspan="7" |40%
⚫
|
  
  +
| rowspan="4" |37%
 
|-
  
|-
 
|5
  
|5
  +
|5%
 
|33%
  
|33%
⚫
|
  
 
|-
  
|-
 
|6
  
|6
  +
|7%
 
|43%
  
|43%
⚫
|
  
 
|-
  
|-
  +
|7
−
|≥7
  
−
|75%
 +
|10%
  +
| rowspan="4" |75%
⚫
|
  
  +
|-
  +
|8
  +
|14%
  +
| rowspan="3" |69%
  +
|-
  +
|9
  +
|20%
  +
|-
  +
|≥10
  +
|27-81%
 
|}
  
|}
 
[[Category:Infectious diseases]]
  
[[Category:Infectious diseases]]

Latest revision as of 12:21, 28 July 2023

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 exists[1]

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
Mortality predicted by PBS for various infections.
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%
  1. ↑ 1.0 1.1 Nakada-Motokawa, N, Miyazaki, T, Ueda, T, et al. Modified Pitt bacteremia score for predicting mortality in patients with candidaemia: A multicentre seven-year retrospective study conducted in Japan. Mycoses. 2021; 64: 1498-1507. https://doi.org/10.1111/myc.13380
  2. ↑ Al-Hasan MN, Lahr BD, Eckel-Passow JE, Baddour LM. Predictive scoring model of mortality in Gram-negative bloodstream infection. Clin Microbiol Infect. 2013 Oct;19(10):948-54. doi: 10.1111/1469-0691.12085. Epub 2012 Nov 27. PMID: 23190091.
  3. ↑ 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
  4. ↑ 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
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