CRAB-RSS: development and validation of a single-center risk stratification model for carbapenem-resistant Acinetobacter baumannii in ICU patients based on mechanical ventilation, carbapenem exposure, and hospitalization duration

CRAB-RSS is a quantitative risk stratification tool derived from a single-center cohort for CRAB infections in intensive care unit patients, demonstrating superior performance to SOFA in local validation. External multicenter validation is warranted before broad clinical implementation. Its innovative features include: (1) a fixed-weighting design (e.g., assigning a baseline score of 2 points for mechanical ventilation), and (2) reliance on only three readily obtainable clinical variables to complete the assessment. Decision curve analysis revealed that the application of CRAB-RSS could reduce unnecessary carbapenem use by 28%-42% across probability thresholds of 10%-30%, with a maximum reduction of 38% achieved at the 20% threshold.