Abstract (english) | Based on our earlier research into the main characteristics and risk factors for infections in
hospitalized
patients with multiple myeloma, we created the numerical Multiple Myeloma Index for
Risk of Infection (MMIRI) to predict infection in myeloma patients. The included factors that could
influence the pathogenesis and incidence of infections were sex, perform
ance status, Durie Salmon
stage of disease, International Staging System, serum creatinine level, immune paresis,
neutropenia,
serum ferritin level, the presence of any catheters, disease duration, stable/progressive disease, and
type of therapy. For each of these parameters, the strength of association with infection was
statistically estimated and specific number of points was assigned to each of these parameters,
proportional to the strength of the association. When designing the MMIRI, we included only
those
parameters that we determined were pathophysiologically associated with the infection. After
further statistical analysis, we identified an optimal cutoff score of 6 or above as indicating a
significant risk for infection, with a sensitivity of 93.2%
and specificity of 80.2%. The scoring system
in the retrospective receiver operating characteristic analysis showed an area under the curve of
0.918. The potential value of the MMIRI is the possibility of identifying those patients who would
benefit from
the prophylactic administration of antibiotics and other anti
-infective measures while
minimizing the contribution to antibiotic resistance related to the overuse of these drugs. As far as
we know, this index represents the first attempt to create such an
instrument for predicting the
occurrence of infections in myeloma patients. |