PURPOSE: The “Eighth Scope of Work Core Measures” of the State of New Jersey have included blood cultures in patients hospitalized for CAP as a standard of care. In order to assess the value of such a “core” measure of quality we reviewed the results of blood cultures obtained in patients hospitalized with CAP.
METHODS: We retrospectively reviewed the medical records of 1325 patients hospitalized for CAP over a period of twelve months. Only patients with enough clinical data to calculate PSI were included in the study. A total of 168 patients (82 males, 86 females age-range: 25-95 years, mean age: 66.5 yrs.) were thus selected for further analysis. Based on the PSI, patients were divided into two groups: Group I with PSI < 130 and Group II with PSI ≥ 130.
RESULTS: Not a single positive blood culture was identified in either group.
CONCLUSION: PSI is not a predictor of bacteremia in patients with CAP. Blood cultures are uniformly negative across the entire spectrum of PSI in CAP.
CLINICAL IMPLICATIONS: Inclusion of mandatory blood cultures in patients hospitalized for CAP as standard of care promulgated by the State of NJ is not only misguided and devoid of any scientific merit but is also wasteful of scarce hospital resources.
DISCLOSURE: Muzamil Sheikh, None.