Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with community-acquired pneumonia in the emergency department

Abstract

Objective. To analyse a new risk score to predict bacte-remia in the patients with Community-acquired Pneumonia (CAP) in the emergency departments. Patients and methods. Prospective and multicenter ob-servational cohort study of the blood cultures ordered in 74 Spanish emergency departments for patients with CAP seen from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the chosen cut-off for getting the sensitivity, specificity, positive predictive value and negative predictive value. Results. A total of 1,020 blood samples wered cultured. True cases of bacteremia were confirmed in 162 (15.9%). The remaining 858 cultures (84.1%) wered negative. And, 59 (5.8%) were judged to be contaminated. The model´s area under the receiver operating characteristic curve was 0.915 (95% CI, 0.898-0.933). The prognostic performance with a model´s cut-off value of ≥ 5 points achieved 97.5% (95% CI, 95.1-99.9) sen-sitivity, 73.2% (95% CI, 70.2-76.2) specificity, 40.9% (95% CI, 36.4-45.1) positive predictive value and 99.4% (95% CI, 99.1-99.8) negative predictive value. Conclusion. The 5MPB-Toledo score is useful for predicting bacteremia in the patients with CAP seen in the emergency departments.