{"id":"https://openalex.org/W7225646281","doi":"https://doi.org/10.3390/medicina62112189","title":"External Validation of the EARL-UTI Score and Exploratory Evaluation of a Procalcitonin-Modified Score for In-Hospital Mortality in Older Adults with Urinary Tract Infection","display_name":"External Validation of the EARL-UTI Score and Exploratory Evaluation of a Procalcitonin-Modified Score for In-Hospital Mortality in Older Adults with Urinary Tract Infection","publication_year":2026,"publication_date":"2026-11-08","ids":{"openalex":"https://openalex.org/W7225646281","doi":"https://doi.org/10.3390/medicina62112189"},"language":"en","primary_location":{"id":"doi:10.3390/medicina62112189","doi":"https://doi.org/10.3390/medicina62112189","is_oa":true,"landing_page_url":"https://doi.org/10.3390/medicina62112189","pdf_url":null,"source":{"id":"https://openalex.org/S1008817457","display_name":"Medicina","issn_l":"1010-660X","issn":["1010-660X","1648-9144"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicina","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/medicina62112189","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5028306287","display_name":"K\u00fcr\u015fat Kaan Kerimo\u011flu","orcid":"https://orcid.org/0009-0002-7519-5546","observed_orcids":["https://orcid.org/0009-0002-7519-5546"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Kursat Kaan Kerimoglu","raw_affiliation_strings":["Department of Emergency, Alsancak Nevvar-Salih Isgoren State Hospital, 35220 Izmir, T\u00fcrkiye"],"raw_orcid":"https://orcid.org/0009-0002-7519-5546","affiliations":[{"raw_affiliation_string":"Department of Emergency, Alsancak Nevvar-Salih Isgoren State Hospital, 35220 Izmir, T\u00fcrkiye","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020823363","display_name":"Ahmet \u00c7a\u011fda\u015f Acara","orcid":"https://orcid.org/0000-0001-6708-7946","observed_orcids":["https://orcid.org/0000-0001-6708-7946"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ahmet Cagdas Acara","raw_affiliation_strings":["Department of Emergency, Alsancak Nevvar-Salih Isgoren State Hospital, 35220 Izmir, T\u00fcrkiye"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Emergency, Alsancak Nevvar-Salih Isgoren State Hospital, 35220 Izmir, T\u00fcrkiye","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5073741370","display_name":"\u015e\u00fckran K\u00f6se","orcid":"https://orcid.org/0000-0002-4228-1213","observed_orcids":["https://orcid.org/0000-0002-4228-1213"]},"institutions":[{"id":"https://openalex.org/I193615760","display_name":"Dokuz Eyl\u00fcl University","ror":"https://ror.org/00dbd8b73","country_code":"TR","type":"education","lineage":["https://openalex.org/I193615760"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Sukran Kose","raw_affiliation_strings":["Department of Infectious Diseases and Clinical Microbiology, Dokuz Eyl\u00fcl University, 35340 Izmir, T\u00fcrkiye"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Infectious Diseases and Clinical Microbiology, Dokuz Eyl\u00fcl University, 35340 Izmir, T\u00fcrkiye","institution_ids":["https://openalex.org/I193615760"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5028306287"],"corresponding_institution_ids":[],"apc_list":{"value":2200,"currency":"CHF","value_usd":2654},"apc_paid":{"value":2200,"currency":"CHF","value_usd":2654},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"62","issue":"11","first_page":"2189","last_page":"2189"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11232","display_name":"Urinary Tract Infections Management","score":0.7645999789237976,"subfield":{"id":"https://openalex.org/subfields/2748","display_name":"Urology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11232","display_name":"Urinary Tract Infections Management","score":0.7645999789237976,"subfield":{"id":"https://openalex.org/subfields/2748","display_name":"Urology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.2012999951839447,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.006300000008195639,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/urinary-tract-infection","display_name":"urinary tract infection","score":0.9559999704360962},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.8830000162124634},{"id":"https://openalex.org/keywords/in-hospital-mortality","display_name":"in-hospital mortality","score":0.9599999785423279},{"id":"https://openalex.org/keywords/mortality-prediction","display_name":"mortality prediction","score":0.734000027179718},{"id":"https://openalex.org/keywords/procalcitonin","display_name":"procalcitonin","score":0.9829999804496765},{"id":"https://openalex.org/keywords/albumin","display_name":"albumin","score":0.8389999866485596},{"id":"https://openalex.org/keywords/external-validation","display_name":"external validation","score":0.6589999794960022},{"id":"https://openalex.org/keywords/discrimination-statistics","display_name":"discrimination (statistics)","score":0.30799999833106995},{"id":"https://openalex.org/keywords/calibration","display_name":"calibration","score":0.6449999809265137},{"id":"https://openalex.org/keywords/decision-curve-analysis","display_name":"decision curve analysis","score":0.9010000228881836},{"id":"https://openalex.org/keywords/emergency-department","display_name":"emergency department","score":0.3970000147819519},{"id":"https://openalex.org/keywords/hospitalized-patients","display_name":"hospitalized patients","score":0.7689999938011169},{"id":"https://openalex.org/keywords/optimism-correction","display_name":"optimism correction","score":0.46299999952316284},{"id":"https://openalex.org/keywords/net-benefit","display_name":"net benefit","score":0.5830000042915344}],"concepts":[{"id":"https://openalex.org/C10936531","wikidata":"https://www.wikidata.org/wiki/Q786600","display_name":"Procalcitonin","level":3,"score":0.8715000152587891},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8371999859809875},{"id":"https://openalex.org/C58471807","wikidata":"https://www.wikidata.org/wiki/Q327120","display_name":"Receiver operating characteristic","level":2,"score":0.7552000284194946},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.5885999798774719},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.5601999759674072},{"id":"https://openalex.org/C76318530","wikidata":"https://www.wikidata.org/wiki/Q16833590","display_name":"Area under the curve","level":2,"score":0.4984999895095825},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.49639999866485596},{"id":"https://openalex.org/C77411442","wikidata":"https://www.wikidata.org/wiki/Q181100","display_name":"Urinary system","level":2,"score":0.4950999915599823},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.447299987077713},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.3747999966144562},{"id":"https://openalex.org/C198433322","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value of tests","level":2,"score":0.32510000467300415},{"id":"https://openalex.org/C204017024","wikidata":"https://www.wikidata.org/wiki/Q485446","display_name":"Optimism","level":2,"score":0.3070000112056732},{"id":"https://openalex.org/C38180746","wikidata":"https://www.wikidata.org/wiki/Q1952580","display_name":"Multivariate analysis","level":2,"score":0.28780001401901245},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.2793999910354614},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.2782999873161316},{"id":"https://openalex.org/C3018260909","wikidata":"https://www.wikidata.org/wiki/Q1322871","display_name":"Exploratory analysis","level":2,"score":0.27480000257492065},{"id":"https://openalex.org/C85973986","wikidata":"https://www.wikidata.org/wiki/Q1091731","display_name":"Exploratory research","level":2,"score":0.2662000060081482},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2630999982357025},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.2612000107765198}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/medicina62112189","doi":"https://doi.org/10.3390/medicina62112189","is_oa":true,"landing_page_url":"https://doi.org/10.3390/medicina62112189","pdf_url":null,"source":{"id":"https://openalex.org/S1008817457","display_name":"Medicina","issn_l":"1010-660X","issn":["1010-660X","1648-9144"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicina","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/medicina62112189","doi":"https://doi.org/10.3390/medicina62112189","is_oa":true,"landing_page_url":"https://doi.org/10.3390/medicina62112189","pdf_url":null,"source":{"id":"https://openalex.org/S1008817457","display_name":"Medicina","issn_l":"1010-660X","issn":["1010-660X","1648-9144"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicina","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":43,"referenced_works":["https://openalex.org/W2790470169","https://openalex.org/W3029838289","https://openalex.org/W3033399596","https://openalex.org/W3044305657","https://openalex.org/W3081497780","https://openalex.org/W3094247010","https://openalex.org/W3095418937","https://openalex.org/W3110192813","https://openalex.org/W3126796228","https://openalex.org/W3138315666","https://openalex.org/W3163616428","https://openalex.org/W3182531029","https://openalex.org/W3194506256","https://openalex.org/W3205452795","https://openalex.org/W4200315254","https://openalex.org/W4205656353","https://openalex.org/W4221051483","https://openalex.org/W4296703128","https://openalex.org/W4306377306","https://openalex.org/W4308772585","https://openalex.org/W4319294909","https://openalex.org/W4323529381","https://openalex.org/W4327740277","https://openalex.org/W4378515930","https://openalex.org/W4385497757","https://openalex.org/W4386995780","https://openalex.org/W4395675508","https://openalex.org/W4396775339","https://openalex.org/W4399425225","https://openalex.org/W4400451425","https://openalex.org/W4400770391","https://openalex.org/W4402096642","https://openalex.org/W4402309080","https://openalex.org/W4403018440","https://openalex.org/W4409362388","https://openalex.org/W4412033213","https://openalex.org/W4412519766","https://openalex.org/W4412571691","https://openalex.org/W4412618533","https://openalex.org/W4414209907","https://openalex.org/W4417159142","https://openalex.org/W7124561479","https://openalex.org/W7124759920"],"related_works":["https://openalex.org/W4417159142","https://openalex.org/W4206226197","https://openalex.org/W3151788359","https://openalex.org/W3037778925","https://openalex.org/W4414209907","https://openalex.org/W4309655246","https://openalex.org/W7124759920","https://openalex.org/W2981420231","https://openalex.org/W4409662090","https://openalex.org/W7140532466"],"abstract_inverted_index":{"Background":[0],"and":[1,35,48,73,118,153,183,205,227,248],"Objectives:":[2],"The":[3,76],"EARL-UTI":[4,33,136,204,215],"score":[5,34],"was":[6,79,92,149,191],"developed":[7],"to":[8,29,36,63],"estimate":[9],"in-hospital":[10,81,232],"mortality":[11],"risk":[12],"in":[13,42,134,219,251,263],"older":[14,225],"adults":[15,226],"with":[16,68,104,174,236],"urinary":[17],"tract":[18],"infection":[19],"(UTI),":[20],"but":[21],"independent":[22,221],"validation":[23],"remains":[24],"limited.":[25],"This":[26,50],"study":[27,54],"aimed":[28],"externally":[30],"validate":[31],"the":[32,95,98,112,239],"explore":[37],"a":[38,64,158,175,179,228],"procalcitonin-modified":[39],"version":[40],"(PEARL-UTI)":[41],"which":[43,243],"procalcitonin":[44,160,237],"replaced":[45],"albumin.":[46],"Materials":[47],"Methods:":[49],"single-center":[51],"retrospective":[52],"cohort":[53,222],"included":[55],"hospitalized":[56,224],"patients":[57],"aged":[58],"\u226565":[59],"years":[60],"who":[61],"presented":[62],"tertiary":[65],"emergency":[66],"department":[67],"UTI":[69],"between":[70],"January":[71],"2021":[72],"December":[74],"2023.":[75],"primary":[77],"outcome":[78],"all-cause":[80],"mortality.":[82,233],"Missing":[83],"predictor":[84],"values":[85],"were":[86,124],"addressed":[87],"using":[88,94],"multiple":[89],"imputation.":[90],"Discrimination":[91],"quantified":[93],"area":[96],"under":[97],"receiver":[99],"operating":[100],"characteristic":[101],"curve":[102,121],"(AUC)":[103],"95%":[105,142,171],"confidence":[106],"intervals":[107],"(CIs).":[108],"Calibration,":[109],"performance":[110],"at":[111,162],"\u22654-point":[113],"threshold,":[114],"bootstrap-based":[115],"optimism":[116],"correction,":[117],"exploratory":[119,240,259],"decision":[120],"analysis":[122],"(DCA)":[123],"also":[125],"assessed.":[126],"Results:":[127],"Among":[128],"158":[129],"patients,":[130],"37":[131],"(23.4%)":[132],"died":[133],"hospital.":[135],"showed":[137,165,196,244],"good":[138,217],"discrimination":[139,168,218,247],"(AUC,":[140,169],"0.819;":[141],"CI,":[143,172],"0.721\u20130.888).":[144],"At":[145],"\u22654":[146],"points,":[147],"sensitivity":[148,176,250],"53.5%,":[150],"specificity":[151,180],"89.8%,":[152],"accuracy":[154,185],"81.3%.":[155],"PEARL-UTI,":[156],"incorporating":[157],"three-point":[159],"component":[161],"\u22652.72":[163],"ng/mL,":[164],"numerically":[166,245],"higher":[167,197,246],"0.910;":[170],"0.823\u20130.957),":[173],"of":[177,181,186,212,223],"81.1%,":[178],"86.7%,":[182],"an":[184],"85.4%.":[187],"Its":[188],"optimism-corrected":[189],"AUC":[190],"0.901.":[192],"Exploratory":[193],"bootstrap-corrected":[194],"DCA":[195],"estimated":[198],"net":[199],"benefit":[200],"for":[201,231],"PEARL-UTI":[202,241,254],"than":[203],"both":[206],"reference":[207],"strategies":[208],"across":[209],"threshold":[210,230],"probabilities":[211],"5\u201397%.":[213],"Conclusions:":[214],"demonstrated":[216],"this":[220,252],"high-specificity":[229],"Replacing":[234],"albumin":[235],"yielded":[238],"score,":[242],"greater":[249],"cohort.":[253],"should":[255],"nevertheless":[256],"be":[257],"considered":[258],"until":[260],"independently":[261],"validated":[262],"larger,":[264],"multicenter":[265],"populations.":[266]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-10T00:00:00"}