a simple model to predict bacteremia in women with acute pyelonephritis：一个简单的模型来预测急性肾盂肾炎妇女菌血症.pdfVIP

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a simple model to predict bacteremia in women with acute pyelonephritis：一个简单的模型来预测急性肾盂肾炎妇女菌血症.pdf

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a simple model to predict bacteremia in women with acute pyelonephritis：一个简单的模型来预测急性肾盂肾炎妇女菌血症

Journal of Infection (2011) 63, 124e130 /journals/jinf A simple model to predict bacteremia in women with acute pyelonephritis Kyung Su Kim a, Kyuseok Kim b,*, You Hwan Jo b, Tae Yun Kim b, Jin Hee Lee b, Se Jong Lee a, Joong Eui Rhee b, Gil Joon Suh a a Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea b Department of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 463-707, Republic of Korea Accepted 10 June 2011 Available online 22 June 2011 KEYWORDS Summary Objectives: To construct a simple model to predict bacteremia in women with un- Pyelonephritis; complicated acute pyelonephritis (APN) for the judicious use of blood cultures. Bacteremia; Methods: A prospective database including 735 women with uncomplicated APN at an aca- Logistic models; demic urban emergency department was analyzed retrospectively. Independent risk factors Risk assessment; were determined using multivariate logistic regression in two-thirds of patients. Cutoff values Community-acquired representing 10% and 30% of risk were selected for the stratiﬁcation. This model was internally infections and externally validated using a remaining one-thirds of patients and 169 independent pa- tients, respectively. Results: Independent risk factors were as follows: age 65 years (odds ratio [OR] Z5.18, 4 points), vomiting (OR Z2.40, 2 points), heart rate 110 beats/min (OR Z2.35, 2 points), seg- mented neutrophils 90% (OR Z 3.17, 3 points), and urine WBC 50/HPF (OR Z4.