Measuring patient-centred long-term outcome following a bloodstream infection: a pilot study

• Published in: Clinical microbiology and infection Vol. 26; no. 2; pp. 257.e1 - 257.e4
• Main Authors: McNamara, J.F., Harris, P.N.A., Chatfield, M.D., Lorenc, P., Paterson, D.L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-02-2020
• Subjects: Bacteraemia; Bloodstream infection; Functional outcome; Mortality; Outcome; Patient-centred; Bacteraemia; Bloodstream infection; Patient-centred; Mortality; Outcome; Functional outcome
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1016/j.cmi.2019.10.011

To evaluate the sequential organ failure assessment (SOFA) and modified SOFA (mSOFA) scoring and a novel performance score based on the Karnofsky score for measuring outcome following a bloodstream infection (BSI).
This prospective observational cohort study assessed patients with BSI for mortality and functional outcomes with a novel performance score: the functional bloodstream infection score (FBIS). We also tested the SOFA and, given the difficulties with measuring SOFA on ward-based patients, the mSOFA over the first 7 days following a BSI for their association with outcomes.
One hundred participants were prospectively recruited. Mortality at 52 weeks following BSI was 21% (21/100). Only 57% of survivors (39/69) were at their baseline functional status at 52 weeks. Stable or improved SOFA/mSOFA over the first 7 days was associated with survival and return to premorbid performance score (risk ratio 3.2, 95%CI 1.3–9.4, p < 0.01).
The acute change in SOFA/mSOFA was associated with 52-week survival and return to premorbid functional performance. The FBIS measurement represents a simple and easy-to-apply measure of functional performance for patients with BSI and was associated with a high response rate (89%) from participants.