Improvement of a clinical prediction rule for clinical trials on prophylaxis for invasive candidiasis in the intensive care unit

Luis Ostrosky-Zeichner, Peter G. Pappas, Shmuel Shoham, Annette Reboli, Michelle A. Barron, Charles Sims, Craig Wood, Jack D. Sobel

    Research output: Contribution to journalArticlepeer-review

    79 Scopus citations

    Abstract

    We created a clinical prediction rule to identify patients at risk of invasive candidiasis (IC) in the intensive care unit (ICU) (Eur J Clin Microbiol Infect Dis 2007; 26:271). The rule applies to <10% of patients in ICUs. We sought to create a more inclusive rule for clinical trials. Retrospective review of patients admitted to ICU ≥ 4 days, collecting risk factors and outcomes. Variations of the rule based on introduction of mechanical ventilation and risk factors were assessed. We reviewed 597 patients with a mean APACHE II score of 14.4, mean ICU stay of 12.5 days and mean ventilation time of 10.7 days. A variation of the rule requiring mechanical ventilation AND central venous catheter AND broad spectrum antibiotics on days 1-3 AND an additional risk factor applied to 18% of patients, maintaining the incidence of IC at 10%. Modification of our original rule resulted in a more inclusive rule for studies.

    Original languageEnglish (US)
    Pages (from-to)46-51
    Number of pages6
    JournalMycoses
    Volume54
    Issue number1
    DOIs
    StatePublished - Jan 2011

    All Science Journal Classification (ASJC) codes

    • Dermatology
    • Infectious Diseases

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