{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:07:41Z","timestamp":1773101261514,"version":"3.50.1"},"reference-count":0,"publisher":"SEMES (Sociedad Espanola de Medicina de Urgencias y Emergencias)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emergencias"],"published-print":{"date-parts":[[2026,3,9]]},"abstract":"<jats:p>Objetivos. Comparar el rendimiento de algoritmos de aprendizaje autom\u00e1tico no supervisado y supervisado con el modelo cl\u00e1sico de regresi\u00f3n log\u00edstica para estratificar el riesgo de padecer bacteriemia en el momento del ingreso en el servicio de urgencias (SU) en los pacientes con hemopat\u00edas malignas.\nM\u00e9todos. Se realiz\u00f3 un estudio de cohorte retrospectivo multic\u00e9ntrico internacional que incluy\u00f3 consultas consecutivas de pacientes adultos con neoplasias hematol\u00f3gicas atendidos en urgencias y con solicitud de hemocultivos; el resultado primario fue la predicci\u00f3n de bacteriemia. El Bacteremia Objective Score System (BOSS)-1 utiliz\u00f3 regresi\u00f3n log\u00edstica multivariable, BOSS-2 emple\u00f3 agrupaci\u00f3n de medias k y BOSS-3 aplic\u00f3 un algoritmo de m\u00e0quina de vectores de soporte. El rendimiento discriminativo se evalu\u00f3 mediante sensibilidad y especificidad. Se realiz\u00f3 una validaci\u00f3n externa de los resultados.\nResultados. La cohorte de derivaci\u00f3n incluy\u00f3 679 visitas al SU. Los hemocultivos fueron positivos en 88 (13%) casos. BOSS-1 identific\u00f3 pacientes de bajo riesgo (3,1% de bacteriemia) con alta sensibilidad (94%; IC 95%: 87-97) pero especificidad limitada (30%; IC 95%: 26-34). BOSS-2 identific\u00f3 mejor los pacientes de alto riesgo [29% de bacteriemia; sensibilidad 93% (IC 95%: 84-97), especificidad 30% (IC 95%: 26-34)]. BOSS-3 permiti\u00f3 clasificar a todos los pacientes en categor\u00edas de bajo (66,8%) o alto riesgo (33,2%), sin grupo intermedio, a diferencia de los otros dos modelos, y mostr\u00f3 el mejor equilibrio entre sensibilidad (61%; IC 95%: 59-64) y especificidad (71%; IC 95%: 70-73) y obtuvo los resultados m\u00e1s reproducibles en la cohorte de validaci\u00f3n externa.\nConclusiones. Los algoritmos BOSS permitieron una estratificaci\u00f3n eficaz del riesgo de bacteriemia en los SU, destacando como mejor potencial cl\u00ednico los modelos de aprendizaje autom\u00e1tico supervisado.<\/jats:p>","DOI":"10.55633\/s3me\/026.2026","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:19:14Z","timestamp":1773062354000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of the Risk of Bacteremia in Patients with Hematologic Malignancies in the Emergency Department: A Comparative Study Between Logistic Regression and Machine Learning Algorithms"],"prefix":"10.55633","author":[{"given":"Antonio","family":"Gallardo-Pizarro","sequence":"first","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Peyrony","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a. Hospital Saint-Louis, Assistance Publique-H\u00f4pitaux de Paris, Par\u00eds, Francia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Teij\u00f3n-Lumbreras","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ainhoa","family":"Castiella-Aranzasti","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Mart\u00ednez-Urrea","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Terrones-Campos","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Francesco Aiello","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Gras","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a.Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique, Par\u00eds, Francia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Castro","sequence":"additional","affiliation":[{"name":"Universidad de Barcelona, Barcelona, Espa\u00f1a.Unidad de Cuidados Intensivos M\u00e9dicos, Hospital Cl\u00ednic de Barcelona \u2013 IDIBAPS, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Pitart","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Cl\u00ednic de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Camelena","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Saint-Louis, Assistance Publique\u2013H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9, Par\u00eds, Francia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Gonz\u00e1lez del Castillo","sequence":"additional","affiliation":[{"name":"Servicio de Urgencias, Hospital Cl\u00ednico San Carlos, Madrid, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Avenda\u00f1o","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario de Salamanca, Salamanca, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d2scar","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"Universidad de Barcelona, Barcelona, Espa\u00f1a.Servicio de Urgencias, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Mensa","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep M","family":"Nicol\u00e1s","sequence":"additional","affiliation":[{"name":"Universidad de Barcelona, Barcelona, Espa\u00f1a.Unidad de Cuidados Intensivos M\u00e9dicos, Hospital Cl\u00ednic de Barcelona \u2013 IDIBAPS, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lex","family":"Soriano","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a.CIBERINF, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Garc\u00eda-Vidal","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic de Barcelona - IDIBAPS, Barcelona, Espa\u00f1a. Universidad de Barcelona, Barcelona, Espa\u00f1a."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"33356","published-online":{"date-parts":[[2026,3,9]]},"container-title":["Emergencias"],"original-title":["Evaluaci\u00f3n del riesgo de bacteriemia en pacientes con neoplasias hematol\u00f3gicas en el servicio de urgencias: estudio comparativo entre regresi\u00f3n log\u00edstica y algoritmos de aprendizaje autom\u00e1tico"],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:19:14Z","timestamp":1773062354000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaemergencias.org\/articulo\/evaluacion-del-riesgo-de-bacteriemia-en-pacientes-con-neoplasias-hematologicas-en-el-servicio-de-urgencias-estudio-comparativo-entre-regresion-logistica-y-algoritmos-de-aprendizaje-automatico\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":0,"URL":"https:\/\/doi.org\/10.55633\/s3me\/026.2026","relation":{},"ISSN":["1137-6821","2386-5857"],"issn-type":[{"value":"1137-6821","type":"print"},{"value":"2386-5857","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}