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Table 3 Sensitivity analysis of models for predicting candidemia

From: Candidemia on presentation to the hospital: development and validation of a risk score

 

Derivation cohort

Validation cohort

Variable

OR (95% CI)

P valuea

OR (95% CI)

P value

Equal weight risk-score model

AUROC b = 0.70; H-L P = 0.39

AUROC = 0.71; H-L P = 0.34

   Number of risk factors present (0--6)

1.93 (1.81--2.04)

< 0.0001

1.89 (1.73--2.06)

< 0.0001

Unequal weight risk model

AUROC = 0.71; H-L P = 0.47

AUROC = 0.72; H-L P = 0.66

   Age < 65 years

2.08 (1.79--2.41)

< 0.0001

1.53 (1.21--1.92)

0.0003

   Temperature ≤ 98°F or severe altered mental statusc

1.43 (1.23--1.66)

< 0.0001

1.43 (1.13--1.81)

0.0030

   Cachexiad

2.16 (1.77--2.64)

< 0.0001

2.01 (1.53--2.65)

< 0.0001

   Prior admission within 30 days

2.54 (2.18--2.96)

< 0.0001

2.50 (1.99--3.15)

< 0.0001

   Admitted from other health care facility

2.28 (1.95--2.66)

< 0.0001

2.06 (1.63--2.60)

< 0.0001

   Mechanical ventilation at admission

1.56 (1.28--1.90)

< 0.0001

2.07 (1.58--2.71)

< 0.0001

Full risk model (16 risk factors)

AUROC = 0.74; H-L P = 0.02

AUROC = 0.73; H-L P = 0.74

   Age < 65 years

2.03 (1.75--2.37)

< 0.0001

1.52 (1.21--1.92)

0.0004

   Admitted from other health care facility

2.27 (1.93--2.65)

< 0.0001

2.06 (1.63--2.61)

< 0.0001

   Mechanical ventilation at admission

1.28 (1.02--1.61)

0.0368

2.03 (1.48--2.78)

< 0.0001

   Metastatic cancer

1.57 (1.20--2.05)

0.0011

1.43 (0.94--2.18)

0.0994

   Tumor

1.47 (1.06--2.02)

0.0202

1.36 (0.85--2.19)

0.2008

   Cachexia

1.99 (1.62--2.43)

< 0.0001

1.82 (1.38--2.41)

< 0.0001

   Pre-admission within 30 days

2.41 (2.07--2.81)

< 0.0001

2.35 (1.86--2.97)

< 0.0001

   Albumin ≤ 1.8 g/dL

1.70 (1.33--2.18)

< 0.0001

1.48 (1.03--2.13)

0.0329

   Albumin 1.9--2.2 g/dL

1.35 (1.05--1.73)

0.0184

1.59 (1.14--2.22)

0.0061

   Potassium > 5.6 mEq/dL

1.61 (1.26--2.06)

0.0002

1.42 (0.97--2.08)

0.0747

   Sodium > 145 mEq/dL

1.30 (1.00--1.68)

0.047

1.51 (1.03--2.20)

0.0345

   Arterial pH < 7.36

1.38 (1.10--1.74)

0.0058

1.00 (0.71--1.41)

0.9896

   Bands > 32%

0.66 (0.49--0.88)

0.0051

0.87 (0.57--1.31)

0.4991

   White blood cells > 27,000/mm3

0.69 (0.52--0.92)

0.0105

1.09 (0.76--1.57)

0.6296

   Temperature ≤ 98°F

1.22 (1.04--1.43)

0.0130

1.52 (1.19--1.95)

0.0009

   Severe altered mental status

1.26 (1.01--1.56)

0.0388

0.94 (0.67--1.33)

0.7403

  1. AUROC = area under receiver operating curve; CI = confidence interval; H-L = Hosmer-Lemshow chi-squared test; OR = odds ratio.
  2. aH-L P values for the three models were determined by Hosmer-Lemshow chi-squared test in which P > 0.05 indicates good model calibration of predicted vs observed candidemia across low- and high-risk deciles. P values for each variable within the models were determined by each logistic regression model in which a significant value indicates increased risk for candidemia.
  3. bAUROC ≥ 0.70 indicates good model discrimination.
  4. cSevere altered mental status defined by Glasgow Coma Scale less than 5 or a designation of coma by a physician.
  5. dCachexia defined by ICD-9 secondary diagnosis code.
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