{rfName}
A

License and use

Altmetrics

Grant support

This study received no financial support. The promoter of this study was the Infectious Disease Group of the Spanish Emergency Medicine Society. This group received financial support from Merck, Tedec-Meiji, Thermo Fisher, ViroGates and GSK in the last year to organise conferences and group meetings. None of the authors has received any financial compensation.

Analysis of institutional authors

Diaz-Honrubia, AjAuthor

Share

September 27, 2021
Publications
>
Article
No

A bacteraemia risk prediction model: development and validation in an emergency medicine population

Publicated to:Infection. 50 (1): 203-221 - 2022-01-01 50(1), DOI: 10.1007/s15010-021-01686-7

Authors: Julian-Jimenez, Agustin; Gonzalez del Castillo, Juan; Garcia-Lamberechts, Eric Jorge; Huarte Sanz, Itziar; Navarro Bustos, Carmen; Rubio Diaz, Rafael; Guardiola Tey, Josep Maria; Llopis-Roca, Ferran; Pinera Salmeron, Pascual; de Martin-Ortiz de Zarate, Mikel; Alvarez-Manzanares, Jesus; Gamazo-Del Rio, Julio Javier; Alvarez Alonso, Marta; Mora Ordonez, Begona; alvarez Lopez, Oscar; Ortega Romero, Maria del Mar; Sousa Reviriego, Maria del Mar; Perales Pardo, Ramon; Villena Garcia del Real, Henrique; Ferreras Amez, Jose Maria; Gonzalez Martinez, Felix; Martin-Sanchez, Francisco Javier; Beneyto Martin, Pedro; Candel Gonzalez, Francisco Javier; Diaz-Honrubia, Antonio Jesus

Affiliations

Complejo Hosp Univ Albacete, Emergency Dept, Albacete, Spain - Author
Complejo Hosp Univ Santiago Compostela, Emergency Dept, Santiago De Compostela, Spain - Author
Complejo Hosp Univ Toledo, Res Unit, Toledo, Spain - Author
Hosp Clin Barcelona, Emergency Dept, Barcelona, Spain - Author
Hosp Clin Univ Lozano Blesa Zaragoza, Emergency Dept, Zaragoza, Spain - Author
Hosp Juan Ramon Jimenez Huelva, Emergency Dept, Huelva, Spain - Author
Hosp Nuestra Senora Prado, Emergency Dept, Talavera De La Reina, Spain - Author
Hosp Univ Basurto, Emergency Dept, Bilbao, Spain - Author
Hosp Univ Bellvitge, Emergency Dept, Barcelona, Spain - Author
Hosp Univ Clin San Carlos, Dept Clin Microbiol, Madrid, Spain - Author
Hosp Univ Clin San Carlos, Emergency Dept, Calle Profesor Martin Lagos Calle Profesor Martin, Madrid 28040, Spain - Author
Hosp Univ Donostia, Emergency Dept, San Sebastian, Spain - Author
Hosp Univ Fuenlabrada, Emergency Dept, Fuenlabrada, Spain - Author
Hosp Univ Galdakao Usansolo, Emergency Dept, Bizkaia, Spain - Author
Hosp Univ Mostoles, Emergency Dept, Madrid, Spain - Author
Hosp Univ Reina Sofia, Emergency Dept, Murcia, Spain - Author
Hosp Univ Rio Hortega, Emergency Dept, Valladolid, Spain - Author
Hosp Univ San Carlos, Hlth Res Inst IdISSC, Madrid, Spain - Author
Hosp Univ Sant Pau, Emergency Dept, Barcelona, Spain - Author
Hosp Univ Virgen Macarena, Emergency Dept, Seville, Spain - Author
Hosp Virgen Luz Cuenca, Emergency Dept, Cuenca, Spain - Author
Hosp Virgen Victoria, Emergency Dept, Malaga, Spain - Author
Univ Castilla La Mancha, Complejo Hosp Univ Toledo, Emergency Dept, Toledo, Spain - Author
Univ Politecn Madrid, ETS Comp Engn, Biomed Technol Ctr, Madrid, Spain - Author
See more

Abstract

Objective Design a risk model to predict bacteraemia in patients attended in emergency departments (ED) for an episode of infection. Methods This was a national, prospective, multicentre, observational cohort study of blood cultures (BC) collected from adult patients (>= 18 years) attended in 71 Spanish EDs from October 1 2019 to March 31, 2020. Variables with a p value < 0.05 were introduced in the univariate analysis together with those of clinical significance. The final selection of variables for the scoring scale was made by logistic regression with selection by introduction. The results obtained were internally validated by dividing the sample in a derivation and a validation cohort. Results A total of 4,439 infectious episodes were included. Of these, 899 (20.25%) were considered as true bacteraemia. A predictive model for bacteraemia was defined with seven variables according to the Bacteraemia Prediction Model of the INFURG-SEMES group (MPB-INFURG-SEMES). The model achieved an area under the curve-receiver operating curve of 0.924 (CI 95%:0.914-0.934) in the derivation cohort, and 0.926 (CI 95%: 0.910-0.942) in the validation cohort. Patients were then split into ten risk categories, and had the following rates of risk: 0.2%(0 points), 0.4%(1 point), 0.9%(2 points), 1.8%(3 points), 4.7%(4 points), 19.1% (5 points), 39.1% (6 points), 56.8% (7 points), 71.1% (8 points), 82.7% (9 points) and 90.1% (10 points). Findings were similar in the validation cohort. The cut-off point of five points provided the best precision with a sensitivity of 95.94%, specificity of 76.28%, positive predictive value of 53.63% and negative predictive value of 98.50%. Conclusion The MPB-INFURG-SEMES model may be useful for the stratification of risk of bacteraemia in adult patients with infection in EDs, together with clinical judgement and other variables independent of the process and the patient.

Keywords

Abdominal infectionAdultAdult patientsAgedAlpha hemolytic streptococcusAntibiotic therapyArticleBacillusBacteraemiaBacteremiaBiomarkersBlood cultureBlood culturesC reactive proteinCentral nervous system infectionClinical decision ruleClinical featureClinical prediction ruleClinical trialCoagulase negative staphylococcusCohort analysisComorbidityControlled studyCorynebacteriumCreatinineDefinitionsDepartmentsDescriptive researchDiagnostic valueDisease severityEmergency health serviceEmergency health servicesEmergency medicineEmergency service, hospitalFemaleGlasgow coma scaleGuidelinesHospital emergency serviceHumanHumansInfectionsLactic acidLeukocyte countLeukocytosisLeukopeniaMajor clinical studyMaleMicrococcusMulticenter studyObservational studyPlatelet countPredictive modelPredictive valuePredictive value of testsPredictorsProcalcitoninPropionibacteriumProspective studiesProspective studyPyrexia idiopathicaRespiratory tract infectionRisk modelRisk scoreSepsisSeptic shockSkin infectionSoft tissue infectionSystolic blood pressureThrombocytopeniaTreatment outcomeUnivariate analysisUrinary tract infection

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Infection due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 15/96, thus managing to position itself as a Q1 (Primer Cuartil), in the category Infectious Diseases.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.98. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 1.79 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 5.91 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-06, the following number of citations:

  • WoS: 18
  • Scopus: 17

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-06:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 24.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 86 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 3.75.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 5 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (DIAZ HONRUBIA, ANTONIO JESUS).