Observational studyMedicine2015
Can We Reduce Negative Blood Cultures With Clinical Scores and Blood Markers? Results From an Observational Cohort Study.
Observational study in Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimizing Triage and Hospitalisation In Adult General Medical Emergency Patients: the TRIAGE Study
Comment Diminuer Les hémocultures Inutiles : Construction et Validation d'un Score prédictif de positivité Des hémocultures en réanimation.
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- [Diagnostic accuracy of procalcitonin for bacteremia in the emergency department: a systematic review].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Pooled it
- The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis.The Journal of infection · 2019Pooled it
- Diagnostic performance of procalcitonin for predicting bloodstream infection and guidance on microbial aetiology: a prospective study at an Egyptian tertiary care hospital.BMC infectious diseases · 2026Article
- Low-Value Blood Culture Use in Adult Emergency Department Patients: A Scoping Review.Emergency medicine Australasia : EMA · 2026Article
- Shapiro Decision Rule, Systemic Inflammatory Response Index, and Systemic Immune-Inflammation Index as Rapid Predictors of Bacteremia in Emergency Department Patients.Infection and drug resistance · 2026Article
- A Retrospective Analysis of the Predictive Role of RDW, MPV, and MPV/PLT Values in 28-Day Mortality of Geriatric Sepsis Patients: Associations with APACHE II and SAPS II Scores.Medicina (Kaunas, Lithuania) · 2025Article
- Developing Machine-Learning Models to Predict Bacteremia in Febrile Adults Presenting to the Emergency Department: A Retrospective Cohort Study from a Large Center.The western journal of emergency medicine · 2025Article
- Leveraging explainable artificial intelligence for early prediction of bloodstream infections using historical electronic health records.PLOS digital health · 2024Article
- A Simple Bacteremia Score for Predicting Bacteremia in Patients with Suspected Infection in the Emergency Department: A Cohort Study.Journal of personalized medicine · 2023Article
- Evaluation of Haematological Parameters and Uric Acid in the Diagnosis of Late Onset Neonatal Sepsis.Cureus · 2023Article
- An evaluation into the use of procalcitonin levels as a biomarker of bacterial sepsis to aid the management of intrapartum pyrexia and chorioamnionitis.AJOG global reports · 2022Article
- [New predictive models of bacteremia in the emergency department: a step forward].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Review
- Association of neutrophil to lymphocyte ratio with preterm necrotizing enterocolitis: a retrospective case-control study.BMC gastroenterology · 2022Article
- Comparison of different sepsis scoring systems and pathways: qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in bacteraemic and non-bacteraemic patients presenting to the emergency department.BMC infectious diseases · 2022Article
- Observational
- Using Classification Tree Analysis to Predict the Type of Infection in Preterm Neonates: Proof of Concept Study.Critical care explorations · 2021Article
- The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis.Diagnostics (Basel, Switzerland) · 2021Review
- Normal procalcitonin, C-reactive protein, and negative blood cultures in infective endocarditis with a massive residual vegetation: a case report.European heart journal. Case reports · 2021Article
- Diagnostic Accuracy and Prognostic Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Septic Patients outside the Intensive Care Unit.Medicina (Kaunas, Lithuania) · 2021Article
- Early prediction of blood stream infection in a prospectively collected cohort.BMC infectious diseases · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Only a small proportion of blood cultures routinely performed in emergency department (ED) patients is positive. Multiple clinical scores and biomarkers have previously been examined for their ability to predict bacteremia. Conclusive clinical validation of these scores and biomarkers is essential.This observational cohort study included patients with suspected infection who had blood culture sampling at ED admission. We assessed 5 clinical scores and admission concentrations of procalcitonin (PCT), C-reactive protein (CRP), lymphocyte and white blood cell counts, the neutrophil-lymphocyte count ratio (NLCR), and the red blood cell distribution width (RDW). Two independent physicians assessed true blood culture positivity. We used logistic regression models with area under the curve (AUC) analysis.Of 1083 patients, 104 (9.6%) had positive blood cultures. Of the clinical scores, the Shapiro score performed best (AUC 0.729). The best biomarkers were PCT (AUC 0.803) and NLCR (AUC 0.700). Combining the Shapiro score with PCT levels significantly increased the AUC to 0.827. Limiting blood cultures only to patients with either a Shapiro score of ≥4 or PCT > 0.1 μg/L would reduce negative sampling by 20.2% while still identifying 100% of positive cultures. Similarly, a Shapiro score ≥3 or PCT >0.25 μg/L would reduce cultures by 41.7% and still identify 96.1% of positive blood cultures.Combination of the Shapiro score with admission levels of PCT can help reduce unnecessary blood cultures with minimal false negative rates.The study was registered on January 9, 2013 at the 'ClinicalTrials.gov' registration web site (NCT01768494).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.