Factores predictores de bacteriemia en los pacientes atendidos en el Servicio de Urgencias por infección

espanolObjetivos. Analizar los factores predictivos de bacteriemia en los pacientes atendidos en el servicio de urgencias (SU) por un episodio de infeccion. Pacientes y metodos. Estudio observacional, retrospectivo, descriptivo y analitico de todos los hemocultivos extraidos en un SU en los pacientes adultos (≥ 18 anos) atendidos por infeccion desde el 1-1-2018 hasta el 1-7-2018. Se realizo seguimiento durante 30 dias. Se analizaron 38 variables independientes (epidemiologicas, de comorbilidad, funcionales, clinicas y analiticas) que pudieran predecir la existencia de bacteriemia. Se realizo un estudio univariado y multivariante mediante regresion logistica. Resultados. Se incluyeron 1.425 episodios de hemocultivos extraidos. De ellos se consideraron como bacteriemias verdaderas 179 (12,6 %) y como HC negativos 1.246 (87,4 %). Entre los negativos, 1.130 (79,3%) no tuvieron crecimiento y 116 (8,1%) se consideraron contaminados. Cinco variables se asociaron de forma significativa como predictoras de bacteriemia verdadera: procalcitonina (PCT) serica ≥ 0,51 ng/ml [odds ratio (OR): 4,52; intervalo de confianza (IC) al 95%: 4,20-4,84; p 38,3°C [OR: 1,60; IC al 95%: 1,29-1,90; p Conclusiones. Existen varios factores disponibles tras una primera valoracion en el SU, entre ellos la PCT serica, la temperatura, la hipotension con/sin criterios de shock septico y la existencia de neoplasia, que predicen la existencia de bacteriemia verdadera. EnglishObjectives. The aim of the study was to analyze predictive factors of bacteraemia in patients seen in the emergency department (ED) for an episode of infectious disease. Patients and methods. Observational, retrospective and descriptive analytical study of all blood cultures extracted in an ED in adult patients (≥ 18 years) seen in ED due to infectious disease from 1-1-2019 to 1-7-2019. The follow-up was carried out during 30 days. Thirty-eight variables for predicting bacteraemia were assessed. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Univariate and multivariate logistic regression analysis was performed. Results. A total of 1,425 blood cultures were finally enrolled in the study. Of those were considered true bacteremia 179 (12.6 %) and as negative blood cultures 1,246 (87.4 %). Amongst negatives, 1,130 (79.3%) without growth and 116 (8.1%) as contaminants blood cultures. Five variables were significantly associated with true bacteraemia: serum procalcitonin (PCT) ≥ 0.51 ng/ml [odds ratio (OR): 4.52; 95% confidence interval (CI): 4.20-4.84, P 38.3°C [OR:1.60; 95% CI:1.29-1.90, P Conclusions. Several factors evaluated in an initial assessment in the ED, including serum PCT, temperature, hypotension (with/without septic shock) and being malignancy, were found to predict true bacteraemia.