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Predictive Performance of Scoring Systems for Mortality Risk in Patients with Cryptococcemia: An Observational Study
Wei-Kai Liao1,2,3,4,5,6, Ming-Shun Hsieh6,7,8, Sung-Yuan Hu1,2,3,4,6
1Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
Journal of Personalized Medicine
|September 28, 2023
Summary
This study evaluated scoring systems to predict mortality in patients with cryptococcal fungemia. The Modified Early Warning Score (MEWS) plus Glasgow Coma Scale (GCS) and the Myco-fungal Infection Severity Score (MEDS) showed the best predictive performance.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Medical Informatics
Background:
- Cryptococcal fungemia, often seen in immunocompromised individuals, carries a high mortality risk.
- Predicting mortality in cryptococcal fungemia is crucial for timely and effective treatment.
- Existing scoring systems may aid in risk stratification for patients with cryptococcal fungemia.
Purpose of the Study:
- To evaluate the performance of various scoring systems in predicting mortality risk in patients with cryptococcal fungemia.
- To identify the most effective scoring system for risk stratification in this patient population.
Main Methods:
- Retrospective study of 42 patients with cryptococcal fungemia confirmed by blood culture.
- Analysis of demographic data, clinical parameters, and outcomes.
- Comparison of the predictive accuracy of Modified Early Warning Score (MEWS), RAPS, qSOFA, MEWS plus GCS, REMS, NEWS, and MEDS using ROC curves and Cox regression.
Main Results:
- The overall mortality rate was 64.3%.
- All evaluated scoring systems demonstrated significant predictive value for mortality.
- The Myco-fungal Infection Severity Score (MEDS) exhibited the highest area under the curve (AUC) at 0.905, indicating superior performance.
Conclusions:
- Various scoring systems are applicable for predicting outcomes in cryptococcal fungemia.
- MEDS demonstrates the best performance among the evaluated systems for predicting mortality.
- Further large-scale prospective studies are recommended to validate these findings.
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