Assessment of risk-adjusted mortality ratio (RAMR) in bloodstream infections using all-patient refined diagnosis-related groups (APR-DRGs).

This article focuses on calculating a risk-adjusted mortality ratio (RAMR) for bloodstream infections (BSIs) using All-Patient Refined Diagnosis-Related Groups (APR-DRGs) and comparing it with the crude mortality rate (CMR). Conducted as a retrospective observational study from 2019 to 2022 in a large tertiary hospital, the study analyzed 2,541 BSIs caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida species. Results showed that RAMR was higher than expected for all pathogens except E. coli, with the greatest excess mortality observed in P. aeruginosa, Candida, and S. aureus infections. The study suggests that RAMR, which adjusts for patient demographics and clinical severity via APR-DRGs, provides a more nuanced and clinically relevant mortality indicator than CMR alone, supporting its use as a complementary metric in antibiotic stewardship programs.