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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.