{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:02:48Z","timestamp":1780128168796,"version":"3.54.0"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"abstract":"<jats:p>\n                    Early identification of gram-negative bacteremia (GN-BSI) in intensive care units (ICUs) remains challenging at the time of blood culture sampling, when clinical signs are often nonspecific and existing diagnostic approaches typically rely on single-timepoint measurements. We conducted a retrospective cohort study of adult ICU patients admitted between July 2022 and January 2024 to investigate whether short-term longitudinal patterns in routinely collected clinical and laboratory data contain diagnostically relevant information for GN-BSI. Clinical and laboratory variables were extracted at three consecutive timepoints (Day \u22122, \u22121, and 0 relative to blood culture collection), and diagnostic models incorporating this temporal information were developed using complementary statistical and machine-learning approaches. Model performance was evaluated on a held-out test set using discrimination, calibration, and decision curve analysis. Among 568 patients, models incorporating short-term longitudinal data demonstrated good and consistent discrimination for GN-BSI (AUC range 0.81\u20130.83). A parsimonious logistic regression model of the mean values of seven predictors achieved an AUC of 0.81, which was not significantly different from the best-performing machine learning model (MILD-SVM, AUC 0.83; bootstrap test,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.728). Diagnostic performance was stable across modeling approaches, indicating robustness of the underlying signal rather than dependence on a specific algorithm. Decision curve analysis suggested a higher net benefit of model-based risk stratification compared with treat-all or treat-none strategies across clinically relevant threshold probabilities. Central venous catheter presence, prior antibiotic use, hemoglobin, creatinine, and albumin consistently emerged as influential predictors. These findings indicate that short-term longitudinal clinical trajectories contain diagnostically meaningful information for GN-BSI at the time of blood culture sampling and support further external validation and prospective evaluation prior to clinical implementation.\n                  <\/jats:p>","DOI":"10.1177\/10815589261451202","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:26:43Z","timestamp":1778070403000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic value of short-term longitudinal clinical and laboratory trajectories for gram-negative bacteremia in intensive care units patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1550-1698","authenticated-orcid":false,"given":"Olcay","family":"Dilken","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"},{"name":"Department of Statistics, Yildiz Technical University, Istanbul, T\u00fcrkiye"},{"name":"Department of Intensive Care Adult, Erasmus MC, University Medical Center Rotterdam, Erasmus University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8122-5663","authenticated-orcid":false,"given":"Ahmet Do\u011fukan","family":"Bayrak","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6311-5428","authenticated-orcid":false,"given":"Okan","family":"Derin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"},{"name":"Epidemiology PhD Program, Graduate School of Health Sciences, Istanbul Medipol University, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8224-4576","authenticated-orcid":false,"given":"U\u011fur","family":"Tekba\u015f","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2036-048X","authenticated-orcid":false,"given":"Mustafa","family":"Alt\u0131nay","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3542-3906","authenticated-orcid":false,"given":"Mehmet Nuri","family":"Yakar","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00fclent","family":"Ergin","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Adult, Erasmus MC, University Medical Center Rotterdam, Erasmus University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4737-7131","authenticated-orcid":false,"given":"Serpil","family":"K\u0131l\u0131\u00e7 Depren","sequence":"additional","affiliation":[{"name":"Department of Statistics, Yildiz Technical University, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-01821-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013511229"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.03.030"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2024.111616"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001142"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11580-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0299884"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-023-08602-4"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-7-106"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0962280220946080"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chemolab.2019.01.002"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Kent S Yu M. 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