Pitt bacteremia score: Difference between revisions
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(Created page with "== Background == * Originally developed to predict mortality with Pseudomonas aeruginosa bacteremia * Now used more broadly for mortality from infections more generally == Components == * Measured at onset of bacteremia {| class="wikitable" !Criterion !Points |- |Fever (°C) ≤35 or ≥40 35.1-36.0 or 39.0-39.9 36.1-38.9 |2 1 0 |- |Hypotension: drop by >30 SBP or >20 DBP, or vasopressors, or SBP <90 |2 |- |Mechanical ventilation |2 |- |Cardiac arrest |4 |- |...")  |
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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<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> |
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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) |
+ | !Points (modified) |
||
|- |
|- |
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− | |Fever (°C) |
+ | | colspan="3" |Fever (°C) |
⚫ | |||
− | ≤35 or ≥40 |
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+ | | ≤35 or ≥40 |
||
⚫ | |||
− | 36.1-38.9 |
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|2 |
|2 |
||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
+ | | 36.1-38.9 |
||
⚫ | |||
⚫ | |||
|- |
|- |
||
|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 |
||
|- |
|- |
||
|Mechanical ventilation |
|Mechanical ventilation |
||
⚫ | |||
|2 |
|2 |
||
|- |
|- |
||
|Cardiac arrest |
|Cardiac arrest |
||
⚫ | |||
|4 |
|4 |
||
|- |
|- |
||
− | |Mental status |
+ | | colspan="3" |Mental status |
⚫ | |||
− | Alert |
||
+ | | Alert |
||
− | Disoriented |
||
− | Stuporous |
||
− | Comatose |
||
|0 |
|0 |
||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
+ | | Disoriented |
||
− | 4 |
||
⚫ | |||
⚫ | |||
⚫ | |||
+ | | Stuporous/comatose |
||
⚫ | |||
⚫ | |||
⚫ | |||
+ | | Comatose |
||
⚫ | |||
⚫ | |||
⚫ | |||
+ | |Dialysis |
||
⚫ | |||
⚫ | |||
|} |
|} |
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|+Mortality predicted by PBS for various infections. |
|+Mortality predicted by PBS for various infections. |
||
!Score |
!Score |
||
− | ! |
+ | !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> |
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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> |
!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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+ | !Candidemia (mPBS) (30-day mortality)<ref name=":0" /> |
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− | ! |
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|- |
|- |
||
|0 |
|0 |
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+ | |≤1% |
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|8% |
|8% |
||
+ | | rowspan="4" |5% |
||
⚫ | |||
+ | | rowspan="4" |14% |
||
⚫ | |||
|- |
|- |
||
|1 |
|1 |
||
⚫ | |||
|5% |
|5% |
||
⚫ | |||
⚫ | |||
|- |
|- |
||
|2 |
|2 |
||
+ | |1.5% |
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|15% |
|15% |
||
⚫ | |||
⚫ | |||
|- |
|- |
||
|3 |
|3 |
||
⚫ | |||
|40% |
|40% |
||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
− | |≥4 |
||
⚫ | |||
⚫ | |||
⚫ | |||
|- |
|- |
||
|4 |
|4 |
||
+ | |3% |
||
|47% |
|47% |
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+ | | rowspan="7" |40% |
||
⚫ | |||
+ | | rowspan="4" |37% |
||
⚫ | |||
|- |
|- |
||
|5 |
|5 |
||
+ | |5% |
||
|33% |
|33% |
||
⚫ | |||
⚫ | |||
|- |
|- |
||
|6 |
|6 |
||
+ | |7% |
||
|43% |
|43% |
||
⚫ | |||
− | | |
||
|- |
|- |
||
⚫ | |||
− | |≥7 |
||
− | | |
+ | |10% |
+ | | rowspan="4" |75% |
||
− | | |
||
− | | |
+ | |- |
⚫ | |||
+ | |14% |
||
+ | | rowspan="3" |69% |
||
+ | |- |
||
+ | |9 |
||
+ | |20% |
||
+ | |- |
||
+ | |≥10 |
||
+ | |27-81% |
||
|} |
|} |
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[[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
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% |
- ↑ 1.0 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
- ↑ 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.
- ↑ 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
- ↑ 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