# Supplementary Contribution of Eastern Cooperative Oncology Group-Performance Status to Quick Sequential Organ Failure Assessment in the Detection of Bacteremia Among Older Patients With Suspected Infections

## TL;DR

Adding a performance status measure to a simple infection severity tool did not improve its ability to detect bloodstream infections in older patients.

## Contribution

Evaluated whether combining ECOG-PS with qSOFA improves bacteremia prediction in older patients.

## Key findings

- 221 out of 1,114 older patients had confirmed bacteremia.
- Adding ECOG-PS to qSOFA did not significantly improve diagnostic accuracy (AUC 0.544 vs. 0.554).

## Abstract

Background

The Quick Sequential Organ Failure Assessment (qSOFA) is a simple method for identifying patients with bacteremia; however, it is not accurate for predicting it. Performance status assessment involves the evaluation of daily activities and could be beneficial in predicting bacteremia. We aimed to evaluate whether adding Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) to qSOFA could improve the prediction of bacteremia diagnosis in older patients admitted with suspected infections.

Methods

Data were gathered from individuals aged ≥65 years who were hospitalized with suspected bacteremia from 2018 to 2019. Two prediction models were contrasted employing logistic regression. The initial model exclusively incorporated the qSOFA score, while the second model integrated the Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) alongside the qSOFA score.

Results

Among 1,114 enrolled patients, 221 (19.8%) had true bacteremia. The area under the curve of the qSOFA+ECOG-PS model did not show a statistically significant improvement in predictive capacity compared with that of the qSOFA model (0.544 vs. 0.554, p=0.162).

Conclusions

Adding the ECOG-PS score did not improve the performance of qSOFA for predicting bacteremia in older patients with suspected infection.