TY - JOUR AU - Roth, Jan A. AU - Tschudin-Sutter, Sarah AU - Dangel, Marc AU - Frei, Reno AU - Battegay, Manuel AU - Widmer, Andreas F. PY - 2017/08/10 Y2 - 2024/03/29 TI - Value of the Pitt Bacteraemia Score to predict short-term mortality in Staphylococcus aureus bloodstream infection: a validation study JF - Swiss Medical Weekly JA - Swiss Med Wkly VL - 147 IS - 3132 SE - Original article DO - 10.4414/smw.2017.14482 UR - https://smw.ch/index.php/smw/article/view/2342 SP - w14482 AB - <p><strong>BACKGROUND AND AIMS</strong> <p>The widely used Pitt Bacteraemia Score (PBS) has repeatedly been described as a risk factor for short-term mortality in <em>Staphylococcus aureus</em> bloodstream infection (BSI), but little is known about its overall predictive performance. We therefore aimed to externally validate the PBS in <em>S. aureus</em> BSIs.</p> <strong>METHODS</strong> <p>We performed a retrospective validation study at the University Hospital Basel. Adult patients with a first episode of methicillin-susceptible <em>S. aureus</em> BSI between January 2008 and December 2013 were eligible for the study. We measured the overall discriminative power of the PBS at day of BSI onset in predicting 30-day all-cause mortality by receiver-operating characteristics analysis. For each PBS cut-off, we calculated the corresponding sensitivity, specificity and predictive values for prediction of 30-day all-cause mortality.</p> <strong>RESULTS</strong> <p>A total of 329 patients were included in the final analysis: The median PBS at BSI onset was 0 (interquartile range, 0–2) with patients suffering from various comorbidities (Charlson Comorbidity Index median 3, interquartile range 1–5). Thirteen percent of patients (43/329) died within 30 days from any cause. At BSI onset, 52% (170/329) of patients had a PBS of zero; the concomitant specificity and positive predictive value for prediction of 30-day all-cause mortality were 0% and 13%, respectively. The overall performance of the PBS in predicting the 30-day all-cause mortality was lower than published, with an area under the curve of 0.711 (95% confidence interval 0.614–0.807; p &lt;0.001).</p> <strong>CONCLUSIONS</strong> <p>For short-term mortality, the PBS had a low predictive value in a patient population with methicillin-susceptible <em>S. aureus</em> BSI. There is a need to improve simple clinical scores to better predict mortality, in particular for <em>S. aureus</em>.</p></p> ER -