External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study

Candidemia is associated with high mortality in critically ill patients. Early diagnosis of candidemia is imperative for starting treatment. Therefore, this study was designed to externally validate the candidemia risk prediction scores. This single-center, retrospective observational study included...

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Main Authors: Nurul Mazni Abdullah, Saw Kian Cheah, Raha Abdul Rahman, Nadia Md Nor, Muhammad Maaya, Qurratu Aini Musthafa
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Journal of Fungi
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Online Access:https://www.mdpi.com/2309-608X/11/3/204
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author Nurul Mazni Abdullah
Saw Kian Cheah
Raha Abdul Rahman
Nadia Md Nor
Muhammad Maaya
Qurratu Aini Musthafa
author_facet Nurul Mazni Abdullah
Saw Kian Cheah
Raha Abdul Rahman
Nadia Md Nor
Muhammad Maaya
Qurratu Aini Musthafa
author_sort Nurul Mazni Abdullah
collection DOAJ
description Candidemia is associated with high mortality in critically ill patients. Early diagnosis of candidemia is imperative for starting treatment. Therefore, this study was designed to externally validate the candidemia risk prediction scores. This single-center, retrospective observational study included all critically ill patients admitted to the intensive care unit at a tertiary referral center from January 2018 to December 2023. The risks and patient outcomes were analyzed using bivariate and multivariate regression analysis. A total of 500 patients were analyzed with 2 dropouts due to incomplete data. Candidemia incidence was 8.86%, with parenteral nutrition and candida colonization identified as independent risk factors. Compared to an established risk prediction score, this study demonstrated a sensitivity of 75.0% [59.7–86.8], a specificity of 65.4% [60.8–69.8], a negative predictive value of 96.4% [94.2–97.8], and a positive predictive value of 17.3% [14.5–20.5]. The candidemia group had a significantly higher mean SOFA score, longer time in ICU, longer hospital length of stay, and higher rates of both ICU and in-hospital mortality. This study shows that the risk prediction score is more effective as a tool for excluding rather than predicting candidemia. We recommend against using it as the sole diagnostic guide.
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issn 2309-608X
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spelling doaj-art-debbd890051640a8aeaf0bafb3f73d532025-08-20T03:43:16ZengMDPI AGJournal of Fungi2309-608X2025-03-0111320410.3390/jof11030204External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational StudyNurul Mazni Abdullah0Saw Kian Cheah1Raha Abdul Rahman2Nadia Md Nor3Muhammad Maaya4Qurratu Aini Musthafa5Department of Anesthesiology and Intensive Care, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latiff, Andar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Anesthesiology and Intensive Care, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latiff, Andar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Anesthesiology and Intensive Care, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latiff, Andar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Anesthesiology and Intensive Care, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latiff, Andar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Anesthesiology and Intensive Care, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latiff, Andar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Anesthesiology and Intensive Care, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latiff, Andar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaCandidemia is associated with high mortality in critically ill patients. Early diagnosis of candidemia is imperative for starting treatment. Therefore, this study was designed to externally validate the candidemia risk prediction scores. This single-center, retrospective observational study included all critically ill patients admitted to the intensive care unit at a tertiary referral center from January 2018 to December 2023. The risks and patient outcomes were analyzed using bivariate and multivariate regression analysis. A total of 500 patients were analyzed with 2 dropouts due to incomplete data. Candidemia incidence was 8.86%, with parenteral nutrition and candida colonization identified as independent risk factors. Compared to an established risk prediction score, this study demonstrated a sensitivity of 75.0% [59.7–86.8], a specificity of 65.4% [60.8–69.8], a negative predictive value of 96.4% [94.2–97.8], and a positive predictive value of 17.3% [14.5–20.5]. The candidemia group had a significantly higher mean SOFA score, longer time in ICU, longer hospital length of stay, and higher rates of both ICU and in-hospital mortality. This study shows that the risk prediction score is more effective as a tool for excluding rather than predicting candidemia. We recommend against using it as the sole diagnostic guide.https://www.mdpi.com/2309-608X/11/3/204candidemiaclinical prediction ruleintensive carerisk factorsacute kidney injury
spellingShingle Nurul Mazni Abdullah
Saw Kian Cheah
Raha Abdul Rahman
Nadia Md Nor
Muhammad Maaya
Qurratu Aini Musthafa
External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study
Journal of Fungi
candidemia
clinical prediction rule
intensive care
risk factors
acute kidney injury
title External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study
title_full External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study
title_fullStr External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study
title_full_unstemmed External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study
title_short External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study
title_sort external validation of risk prediction score for candidemia in critically ill patients a retrospective observational study
topic candidemia
clinical prediction rule
intensive care
risk factors
acute kidney injury
url https://www.mdpi.com/2309-608X/11/3/204
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AT rahaabdulrahman externalvalidationofriskpredictionscoreforcandidemiaincriticallyillpatientsaretrospectiveobservationalstudy
AT nadiamdnor externalvalidationofriskpredictionscoreforcandidemiaincriticallyillpatientsaretrospectiveobservationalstudy
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