scholarly journals Validation of the mTICCS Score as a Useful Tool for the Early Prediction of a Massive Transfusion in Patients with a Traumatic Hemorrhage

2020 ◽  
Vol 9 (4) ◽  
pp. 945 ◽  
Author(s):  
Klemens Horst ◽  
Rachel Lentzen ◽  
Martin Tonglet ◽  
Ümit Mert ◽  
Philipp Lichte ◽  
...  
Keyword(s):  
Massive Transfusion ◽  
Early Stage ◽  
Scoring Systems ◽  
Clinical Score ◽  
Predictive Values ◽  
Emergency Situations ◽  
Severe Hemorrhage ◽  
Patients At Risk ◽  
Level I ◽  
Sensitivity Specificity

The modified Trauma-Induced Coagulopathy Clinical Score (mTICCS) presents a new scoring system for the early detection of the need for a massive transfusion (MT). While validated in a large trauma cohort, the comparison of mTICCS to established scoring systems is missing. This study therefore validated the ability of six scoring systems to stratify patients at risk for an MT at an early stage after trauma. A dataset of severely injured patients (ISS ≥ 16) derived from the database of a level I trauma center (2010–2015) was used. Scoring systems assessed were Trauma-Associated Severe Hemorrhage (TASH) score, Prince of Wales Hospital (PWH) score, Larson score, Assessment of Blood Consumption (ABC) score, Emergency Transfusion Score (ETS), and mTICCS. Demographics, diagnostic data, mechanism of injury, injury pattern (graded by AIS), and outcome (length of stay, mortality) were analyzed. Scores were calculated, and the area under the receiver operating characteristic curves (AUCs) were evaluated. From the AUCs, the cut-off point with the best relationship of sensitivity-to-specificity was used to recalculate sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV). A total of 479 patients were included; of those, blunt trauma occurred in 92.3% of patients. The mean age of patients was 49 ± 22 years with a mean ISS of 25 ± 29. The overall MT rate was 8.4% (n = 40). The TASH score had the highest overall accuracy as reflected by an AUC of 0.782 followed by the mTICCS (0.776). The ETS was the most sensitive (80%), whereas the TASH score had the highest specificity (82%) and the PWH score had the lowest (51.83%). At a cut-off > 5 points, the mTICCS score showed a sensitivity of 77.5% and a specificity of 74.03%. Compared to sophisticated systems, using a higher number of weighted variables, the newly developed mTICCS presents a useful tool to predict the need for an MT in a prehospital situation. This might accelerate the diagnosis of an MT in emergency situations. However, prospective validations are needed to improve the development process and use of scoring systems in the future.

scholarly journals Comparison of saliva with healthcare workers- and patient-collected swabs in the diagnosis of COVID-19 in a large cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitnala Sasikala ◽  
Yelamanchili Sadhana ◽  
Ketavarapu Vijayasarathy ◽  
Anand Gupta ◽  
Sarala Kumari Daram ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Early Stage ◽  
Cost Effective ◽  
Hospitalized Patients ◽  
Detection Sensitivity ◽  
Nasopharyngeal Swab ◽  
Predictive Values ◽  
Qrt Pcr ◽  
Asymptomatic Patients ◽  
Sensitivity Specificity

Abstract Background A considerable amount of evidence demonstrates the potential of saliva in the diagnosis of COVID-19. Our aim was to determine the sensitivity of saliva versus swabs collected by healthcare workers (HCWs) and patients themselves to assess whether saliva detection can be offered as a cost-effective, risk-free method of SARS-CoV-2 detection. Methods This study was conducted in a hospital involving outpatients and hospitalized patients. A total of 3018 outpatients were tested. Of these, 200 qRT-PCR-confirmed SARS-CoV-2-positive patients were recruited for further study. In addition, 101 SARS-CoV-2-positive hospitalized patients with symptoms were also enrolled in the study. From outpatients, HCWs collected nasopharyngeal swabs (NPS), saliva were obtained. From inpatients, HCWs collected swabs, patient-collected swabs, and saliva were obtained. qRT-PCR was performed to detect SARS-CoV-2 by TAQPATH assay to determine the sensitivity of saliva detection. Sensitivity, specificity and positive/negative predictive values (PPV, NPV) of detecting SARS-CoV-2 were calculated using MedCalc. Results Of 3018 outpatients (asymptomatic: 2683, symptomatic: 335) tested by qRT-PCR, 200 were positive (males: 140, females: 60; aged 37.9 ± 12.8 years; (81 asymptomatic, 119 symptomatic). Of these, saliva was positive in 128 (64%); 39 of 81 asymptomatic (47%),89 of 119 symptomatic patients (74.8%). Sensitivity of detection was 60.9% (55.4–66.3%, CI 95%), with a negative predictive value of 36%(32.9–39.2%, CI 95%).Among 101 hospitalized patients (males:65, females: 36; aged 53.48 ± 15.6 years), with HCW collected NPS as comparator, sensitivity of saliva was 56.1% (47.5–64.5, CI 95%), specificity 63.5%(50.4–75.3, CI95%) with PPV of 77.2% and NPV of 39.6% and that of self-swab was 52.3%(44–60.5%, CI95%), specificity 56.6% (42.3–70.2%, CI95%) with PPV 77.2% and NPV29.7%. Comparison of positivity with the onset of symptoms revealed highest detection in saliva on day 3 after onset of symptoms. Additionally, only saliva was positive in 13 (12.8%) hospitalized patients. Conclusion Saliva which is easier to collect than nasopharyngeal swab is a viable alternate to detect SARS-COV-2 in symptomatic patients in the early stage of onset of symptoms. Although saliva is currently not recommended for screening asymptomatic patients, optimization of collection and uniform timing of sampling might improve the sensitivity enabling its use as a screening tool at community level.

scholarly journals Scoring systems for early prediction of tibial fracture non-union: an update

2021 ◽  
Author(s):  
George D. Chloros ◽  
Nikolaos K. Kanakaris ◽  
James S. H. Vun ◽  
Anthony Howard ◽  
Peter V. Giannoudis
Keyword(s):  
Tibial Fracture ◽  
Scoring Systems ◽  
Trauma Centre ◽  
Predictive Values ◽  
Non Union ◽  
Post Operative Period ◽  
Male Patients ◽  
Level I ◽  
Healing Score ◽  
Tibial Shaft Fractures

Abstract Purpose To evaluate the available tibial fracture non-union prediction scores and to analyse their strengths, weaknesses, and limitations. Methods The first part consisted of a systematic method of locating the currently available clinico-radiological non-union prediction scores. The second part of the investigation consisted of comparing the validity of the non-union prediction scores in 15 patients with tibial shaft fractures randomly selected from a Level I trauma centre prospectively collected database who were treated with intramedullary nailing. Results Four scoring systems identified: The Leeds-Genoa Non-Union Index (LEG-NUI), the Non-Union Determination Score (NURD), the FRACTING score, and the Tibial Fracture Healing Score (TFHS). Patients demographics: Non-union group: five male patients, mean age 36.4 years (18–50); Union group: ten patients (8 males) with mean age 39.8 years (20–66). The following score thresholds were used to calculate positive and negative predictive values for non-union: FRACTING score ≥ 7 at the immediate post-operative period, LEG-NUI score ≥ 5 within 12 weeks, NURD score ≥ 9 at the immediate post-operative period, and TFHS < 3 at 12 weeks. For the FRACTING, LEG-NUI and NURD scores, the positive predictive values for the development of non-union were 80, 100, 40% respectively, whereas the negative predictive values were 60, 90 and 90%. The TFHS could not be retrospectively calculated for robust accuracy. Conclusion The LEG-NUI had the best combination of positive and negative predictive values for early identification of non-union. Based on this study, all currently available scores have inherent strengths and limitations. Several recommendations to improve future score designs are outlined herein to better tackle this devastating, and yet, unsolved problem.

scholarly journals The Role of Modified Early Warning Score (MEWS) in the Prognosis of Acute Pancreatitis

2021 ◽  
Vol 36 (3) ◽  
pp. e272-e272
Author(s):  
Amena Khan ◽  
Digvijoy Sarma ◽  
Chiranth Gowda ◽  
Gabriel Rodrigues
Keyword(s):  
Acute Pancreatitis ◽  
Early Warning ◽  
Prognostic Score ◽  
Scoring Systems ◽  
Early Warning Score ◽  
Predictive Values ◽  
True Value ◽  
Resource Limited ◽  
Primary Health Care Centers ◽  
Sensitivity Specificity

Objectives: Modified Early Warning Score (MEWS) is a reliable, safe, instant, and inexpensive score for prognosticating patients with acute pancreatitis (AP) due to its ability to reflect ongoing changes of the systemic inflammatory response syndrome associated with AP. Our study sought to determine an optimal MEWS value in predicting severity in AP and determine its accuracy in doing so. Methods: Patients diagnosed with AP and admitted to a single institution were analyzed to determine the value of MEWS in identifying severe AP (SAP). The highest MEWS (hMEWS) score for the day and the mean of all the scores of a given day (mMEWS) were determined for each day. Sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) were calculated for the optimal MEWS values obtained. Results: Two hundred patients were included in the study. The data suggested that an hMEWS value > 2 on day one is most accurate in predicting SAP, with a specificity of 90.8% and PPV of 83.3%. An mMEWS of > 1.2 on day two was the most accurate in predicting SAP, with a sensitivity of 81.2%, specificity of 76.6%, PPV of 69.8%, and NPV of 85.9%. These were found to be more accurate than previous studies. Conclusions: MEWS provides a novel, easy, instant, repeatable, and reliable prognostic score that is comparable, if not superior, to existing scoring systems. However, its true value may lie in its use in resource-limited settings such as primary health care centers.

scholarly journals 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

2021 ◽  
Author(s):  
Rebecca Sparks ◽  
Arisa Harada ◽  
Ruchir Chavada ◽  
Christopher Trethewy
Keyword(s):  
Emergency Department ◽  
Retrospective Cohort ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Blood Cultures ◽  
High Morbidity ◽  
Patients At Risk ◽  
Organ Failure Score ◽  
Sensitivity Specificity ◽  
Related Mortality

Abstract Background Bacteraemia is associated with high morbidity and mortality, with delayed antibiotic treatment associated with poorer outcomes. Early identification is challenging, but clinically important. Multiple scoring systems have been developed to identify individuals in the broader categories of sepsis. We designed this study to assess the performance of existing scoring systems and pathways - CEC SEPSIS KILLS pathway, quick sequential organ failure score (qSOFA), systemic inflammatory response syndrome (SIRS) and the Shapiro criteria. Methods This was a retrospective cohort study performed in two metropolitan hospitals in NSW, consisting of adult patients (>18 years) with positive blood cultures containing a true pathogen and patients matched by age without positive blood cultures. Performance (sensitivity, specificity, and mortality prediction) of recognised sepsis and bacteraemia criteria and pathways - qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in the first 4 hours following ED triage was assessed. Results There were 251 patients in each cohort. Sepsis-related mortality was higher in the bacteraemic group (OR 0.4, p=0.03). Of the criteria studied, the modified Shapiro criteria had the highest sensitivity (88%) with modest specificity (37.85%), and qSOFA had the highest specificity (83.67%) with poor sensitivity (19.82%). SIRS had reasonable sensitivity (82.07%), with poor sensitivity (20.72%). The CEC SEPSIS pathway sensitivity of 70.1% and specificity of 71.1%. The SEPSIS KILLS was activated on only 14% of bacteraemic patients. Conclusion The performance of all scoring systems and pathways was suboptimal in the identification of patients at risk of bacteraemia presenting to the emergency department.

Validation of plasma miR-371a-3p expression in patients with metastatic and early stage germ cell tumor.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 526-526 ◽  
Author(s):  
Lucia Nappi ◽  
Marisa Thi ◽  
Amy Lum ◽  
David Huntsman ◽  
Bernhard J. Eigl ◽  
...  
Keyword(s):  
Germ Cell ◽  
Validation Cohort ◽  
Early Stage ◽  
Clinical Stage ◽  
Diagnostic Tools ◽  
Rt Pcr ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Cell Malignancy

526 Background: Identification of relapsing/residual viable germ cell malignancy (GCM) is often challenging in patients with CSI on surveillance or with residual post-chemotherapy disease. The presence of a biomarker for GCM would overcome the uncertainty of the current methods and improve the quality of care of those patients. Methods: A 2-cohorts pilot study involving patients with clearcut evidence of GCM (clinical stage IS, metastatic and GCM prior orchiectomy) for the development cohort and patients with CSI with or without signs of tumor relapse and patients with metastatic GCM post-chemotherapy for the validation cohort. Blood samples collected in Streck tubes were obtained prior to chemotherapy for the development cohort and post-orchiectomy, at the time of suspicious relapse or post-chemotherapy in the validation cohort. Plasma miR-371a-3p (miR371) was analyzed by RT-PCR. Positive predictive value (PPV), sensitivity, specificity, negative predictive values (NPV) and AUC of the ROC for miR371 and standard diagnostic tools (CT scan, AFP, BHCG and LDH) were calculated correlating qualitative miR371 expression to the presence of viable GCM. Results: 132 patients were enrolled into the development (33 pts) and validation (99 pts) cohorts. Within the development cohort 31/33 pts were miR371 positive, 2/33 pts were negative. 31 true positives were found among the 31 miR371 positive patients for a PPV of 100% (31/31). Two true negatives were found among the 2 patients who had no miR371 expression identified (teratoma, lymphoma). The validation cohort was chosen to evaluate the methodology among patients with predicted lower volumes or no clinically apparent disease. 13/99 patients within the validation cohort were miR371 positive and all 13 had subsequent confirmation of viable GCM. For the overall study of 132 pts, PPV was 100% (46/46), NPV 98%, sensitivity 96% and specificity 100%, the AUC of the ROC was 0.96. Conclusions: Detectable circulating miR-371a-3p levels predict viable GCM and may represent a strategy for biological rather than radiographic assessment for surveillance of early stage and for post-treatment patients. Larger studies to validate these and like results have been planned.

External Validation of Different Scoring Systems for Suspected Choledocholithiasis

2019 ◽  
Vol 36 (6) ◽  
pp. 530-538
Author(s):  
Nicolò Tamini ◽  
Davide Paolo Bernasconi ◽  
Luca Gianotti
Keyword(s):  
Operating Characteristic ◽  
Bile Duct Stone ◽  
Characteristic Curve ◽  
External Validation ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Youden Index ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Symptoms And Signs

Aim of the Study: The diagnosis of choledocholithiasis is challenging. Previously published scoring systems designed to calculate the risk of choledocholithiasis were evaluated to appraise the diagnostic performance. Patients and Methods: Data of patients who were admitted between 2013 and 2015 with the following characteristics were retrieved: bile stone-related symptoms and signs, and indication to laparoscopic cholecystectomy. To validate and appraise the performance of the 6 scoring systems, the acknowledged domains of each metrics were applied to the present cohort. Sensitivity, specificity, positive, negative predictive, Youden index, and receiver operating characteristic curve with the area under the curve (AUC) values of the scores were calculated. Results: Two-hundred patients were analyzed. The highest sensitivity and specificity were obtained from the Menezes’ (96.6%) and Telem’s (99.3%) metrics respectively. The Telem’s and Menezes’ scores had the best positive (75.0%) and negative (96.4%) predictive values respectively. The best accuracy, as computed by the Youden index and AUC, was found for the Soltan’s scoring system (0.628 and 0.88, respectively). Conclusion: The available scoring systems are precise only in identifying patients with a negligible risk of common bile duct stone, but overall insufficiently accurate to suggest the routine use in clinical practice.

Elevated Faecal Calprotectin Levels are a Reliable Non-Invasive Screening Tool for Small Bowel Crohn’s Disease in Patients Undergoing Capsule Endoscopy

2018 ◽  
Vol 36 (3) ◽  
pp. 202-208 ◽  
Author(s):  
Hamid Yousuf ◽  
Umair Aleem ◽  
Roisin Egan ◽  
Pardeep Maheshwari ◽  
Jafaar Mohamad ◽  
...  
Keyword(s):  
At Risk ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Characteristic Analysis ◽  
Faecal Calprotectin ◽  
Predictive Values ◽  
Patients At Risk ◽  
Sensitivity Specificity

Background: Approximately 10% of Crohn’s disease (CD) patients have this disease affecting the small bowel (SB) beyond the reach of Ileo-colonoscopy. Capsule endoscopy (SBCE) is the recommended investigation for SB disease. An accurate and inexpensive biomarker would help identify at-risk patients. Aim: To examine the efficacy of faecal calprotectin (FC) and C-reactive protein (CRP) as predictors of SBCE findings in suspected and known CD. Methods: A prospective observational study. Consecutive patients referred for SBCE gave FC and CRP samples. The diagnostic accuracy for SB CD based on SBCE result was calculated for both FC and CRP. Results: Of 100 invitees, FC and SBCE results were available in 64 cases. Correlation between FC >50 µg/g and SBCE result was poor К = 0.163; sensitivity, specificity, positive predictive value (PPV) and negative predictive values for ileitis were 60, 61, 32 and 83% respectively. PPV and specificity improved at FC >100 µg/g, 76 and 40%, correlation remained fair, К = 0.259. Receiver operating characteristic analysis had a sensitivity of 47% and specificity of 90% for FC >194 µg/g. CRP alone or in combination was an inaccurate predictor of ileitis. Conclusion: Our study suggests that FC level >194 µg/g may be a useful SBCE filter test, identifying patients at risk of SB CD.

scholarly journals mTICCS and its inter-rater reliability to predict the need for massive transfusion in severely injured patients

2020 ◽  
Author(s):  
Klemens Horst ◽  
Philipp Lichte ◽  
Felix Bläsius ◽  
Christian David Weber ◽  
Martin Tonglet ◽  
...  
Keyword(s):  
Massive Transfusion ◽  
Scoring Systems ◽  
Clinical Score ◽  
Trauma Centre ◽  
Medical Professionals ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Rater Reliability ◽  
Significant Difference ◽  
Injured Patients

Abstract Purpose The modified Trauma-Induced Coagulopathy Clinical Score (mTICCS) presents a new scoring system for the early detection of the need for a massive transfusion (MT). This easily applicable score was validated in a large trauma cohort and proven comparable to more established complex scoring systems. However, the inter-rater reliability of the mTICCS has not yet been investigated. Methods Therefore, a dataset of 15 randomly selected and severely injured patients (ISS ≥ 16) derived from the database of a level I trauma centre (2010–2015) was used. Moreover, 15 severely injured subjects that received MT were chosen from the same databank. A web-based survey was sent to medical professionals working in the field of trauma care asking them to evaluate each patient using the mTICCS. Results In total, 16 raters (9 residents and 7 specialists) completed the survey. Ratings from 15 medical professionals could be evaluated and led to an ICC of 0.7587 (95% Bootstrap confidence interval (BCI) 0.7149–0.8283). A comparison of working experience specific ICC (n = 7 specialists, ICC: 0.7558, BCI: 0.7076–0.8270; n = 8 residents, ICC: 0.7634, BCI: 0.7183–0.8335) showed no significant difference between the two groups (p = 0.67). Conclusion In summary, reliability values need to be considered when making clinical decisions based on scoring systems. Due to its easy applicability and its almost perfect inter-rater reliability, even with non-specialists, the mTICCS might therefore be a useful tool to predict the early need for MT in multiple trauma.

Validation of the Red Flags Index for Early Diagnosis of Crohn’s Disease: A Prospective Observational IG-IBD Study Among General Practitioners

2020 ◽  
Vol 14 (12) ◽  
pp. 1777-1779
Author(s):  
Gionata Fiorino ◽  
Stefanos Bonovas ◽  
Daniela Gilardi ◽  
Antonio Di Sabatino ◽  
Mariangela Allocca ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Practitioners ◽  
Early Stage ◽  
Diagnostic Delay ◽  
Diagnostic Strategy ◽  
Red Flags ◽  
Faecal Calprotectin ◽  
Predictive Values ◽  
Sensitivity Specificity

Abstract Introduction Diagnostic delay &gt;12 months is frequent in Crohn’s disease [CD]. Recently, the International Organization for Inflammatory Bowel Disease [IO-IBD] developed a tool to identify early CD and reduce diagnostic delay. Subjects with an index ≥8 are more likely to have suspected CD (odds ratio [OR] 205, p &lt;0.0001). We aimed to validate this questionnaire at the community level in patients seen by the general practitioners [GPs] in two large areas of Lombardy, Italy. Methods Consecutive adult patients referring to the GP were screened. The GPs administered the Red Flags [RF] questionnaire to the eligible patients. All patients were referred to the nearest participating centre to confirm or exclude the diagnosis of CD. Sensitivity, specificity, and positive and negative predictive values [PPV, NPV] of the RF index [RFI] were calculated. Patients lost to follow-up after the first gastroenterological visit were analysed using a non-responder imputation, assuming they were negative for CD diagnosis. Results From November 2016 to November 2019, 112 patients were included. A total of 66 subjects [59%] completed the study after the first gastroenterological visit. The prevalence of CD was 3.6% in the study population [4/112]. The RF index had 50% sensitivity, 58% specificity, 4% PPV, and 97% NPV. A combined diagnostic strategy with faecal calprotectin [FC] [RFI ≥8 and/or FC &gt;250 ng/g] resulted in significantly improved accuracy: sensitivity 100% [29–100%], specificity 72% [55–85%], PPV = 21% [5–51%], NPV = 100% [88–100%]. Conclusions The RF Index combined with FC is a valid tool to identify patients with high probability of having CD at early stage.

scholarly journals 1482. Local validation of the drug resistance in pneumonia clinical prediction score at a large academic medical center and a community hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S742-S743
Author(s):  
Jennifer L Reinhard ◽  
Ramy H Elshaboury ◽  
Bryan D Hayes ◽  
Jason Mallada ◽  
Molly L Paras ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Primary Outcome ◽  
Medical Center ◽  
Academic Medical Center ◽  
Local Population ◽  
Community Acquired Pneumonia ◽  
Respiratory Pathogens ◽  
Predictive Values ◽  
Patients At Risk ◽  
Sensitivity Specificity

Abstract Background Community-acquired pneumonia (CAP) is responsible for ~1 million emergency department (ED) visits yearly and the leading cause of infection-related deaths. Given that increasing antibiotic resistance rates complicate appropriate empiric antibiotic selection, clinicians may benefit from tools to help identify patients at risk for drug-resistant pathogens (DRPs). Limitations of traditional tools, such as healthcare-associated pneumonia criteria (HCAP), have led to development of novel scoring tools such as the drug resistance in pneumonia (DRIP) score. Webb et al. showed the DRIP score was more predictive of CAP caused by DRPs than HCAP criteria. The objective of this study was to validate the DRIP score in a local population of hospitalized patients at an academic and a community medical center. Methods Patients who presented to the ED between May 2017 and May 2019 were included in this retrospective review. Patients were included if they were ≥ 18 years diagnosed with CAP by radiographic evidence with respiratory culture positivity and susceptibility results. Exclusion criteria were: presence of non-bacterial non-respiratory pathogens, patients with cystic fibrosis, lung transplant or systemic co-infections. The primary outcome was validation of the DRIP score by comparing the sensitivity, specificity, negative and positive predictive values (NPV/PPV) to the derivation and validation study by Webb et al. Secondary outcomes were the percentage of CAP cases with DRPs and the predictability of DRP using the DRIP score versus HCAP criteria. Results A total of 164 patients were included; 60.4% were male with a median age of 70 years. The primary outcome shown in Table 1 demonstrated similar sensitivity, specificity, NPV, and PPV of the DRIP score to those in the study by Webb et al. Staphylococcus aureus (32.9%) and Streptococcus pneumoniae (27.4%) were the most commonly isolated pathogens and CAP due to DRPs occurred in 30.5% of patients. The DRIP score also demonstrated improved performance in predicting DRPs in CAP compared to the HCAP Criteria as shown in Table 2. Table 1. DRIP Score Validation Table 2. Predictability of the DRIP score vs. HCAP criteria Conclusion Our results further validate the DRIP score derived by Webb et al. in predicting DRPs in CAP. These results encourage a local prospective evaluation of the DRIP score as an antimicrobial stewardship tool. Disclosures All Authors: No reported disclosures

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