Candidaemia and a risk predictive model for overall mortality: a prospective multicentre study

Area of Science:

• Infectious Diseases
• Clinical Epidemiology
• Medical Informatics

Background:

• Candidaemia is a serious bloodstream infection with significant mortality rates.
• Previous studies identified mortality predictors but lacked a validated predictive model.
• This study aimed to update the epidemiology of candidaemia and develop a predictive tool.

Purpose of the Study:

• To describe the current epidemiology of candidaemia in Australia.
• To identify predictors of 30-day all-cause mortality.
• To develop and validate a clinical risk prediction model for candidaemia mortality.

Main Methods:

• Prospective study of adult candidaemia patients across eight Australian institutions over 12 months.
• Multivariate analysis of clinical and laboratory variables at diagnosis to identify mortality predictors.
• Development and validation of a risk score using receiver operating characteristic curves and a historical dataset.

Main Results:

• A total of 133 patients were included; 31% experienced 30-day all-cause mortality.
• Factors associated with increased mortality included older age, ICU admission, and specific comorbidities.
• A validated risk score was developed, stratifying patients into low (<20%) and high (≥20%) predicted 30-day mortality risk.

Conclusions:

• Candidaemia continues to be associated with high mortality.
• A simple, validated risk score is presented to aid in stratifying patient mortality risk at diagnosis.
• The model's ease of integration into decision support systems warrants further validation.