Prognostic Value of the Pitt Bacteremia Score for 7-Day Mortality in Hospitalized Adults with Bacteremia and Low-to-Moderate Comorbidity Burden: A Retrospective Cohort Study from Indonesia

The Pitt Bacteremia Score (PBS) grades bedside severity, but its discrimination varies across settings and its conventional threshold of 4 has been questioned. This single-centre retrospective cohort study included 74 randomly sampled adults with culture-confirmed bacteremia and an updated Charlson Comorbidity Index below 4 at an Indonesian tertiary referral hospital. The PBS was calculated from the worst values recorded from 24 h before to 24 h after blood-culture collection. Discrimination for 7-day mortality was assessed by receiver operating characteristic analysis, the threshold maximizing the Youden index (YI) was examined by bootstrap resampling, and associations were estimated by Firth logistic regression. Thirty-two patients (43.2%) died within 7 days. The PBS discriminated non-survivors from survivors (AUC 0.900; 95% CI [0.824–0.975]), and in this cohort the YI was maximal at 4 (sensitivity 90.6%, specificity 81.0%), although thresholds of 3 to 5 could not be statistically distinguished. After excluding patients with cardiac arrest, the AUC was 0.790 (95% CI [0.633–0.946]). Seven-day mortality was 78.4% with a PBS of 4 or above (OR 34.21; 95% CI [9.99–152.79]), and the association persisted after adjustment for age, sex, multidrug-resistant organism status, and empirical antibiotic therapy concordance, although its magnitude was imprecisely estimated. These findings require external confirmation.