Comparison of severity of illness scoring systems for patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

Alexandre R Marra; Gonzalo M L Bearman; Richard P Wenzel; Michael B Edmond

doi:10.1186/1471-2334-6-132

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Comparison of severity of illness scoring systems for patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

Journal article

Open access

Peer reviewed

Comparison of severity of illness scoring systems for patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

Alexandre R Marra, Gonzalo M L Bearman, Richard P Wenzel and Michael B Edmond

BMC infectious diseases, Vol.6(1), 132

08/17/2006

DOI: 10.1186/1471-2334-6-132

PMCID: PMC1563469

PMID: 16916466

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Abstract

Several acute illness severity scores have been proposed for evaluating patients on admission to intensive care units but these have not been compared for patients with nosocomial bloodstream infection (nBSI). We compared three severity of illness scoring systems for predicting mortality in patients with nBSI due to Pseudomonas aeruginosa. We performed a historical cohort study on 63 adults in intensive care units with P. aeruginosa monomicrobial nBSI. The Acute Physiology, Age, Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiologic Score (SAPS II), were calculated daily from 2 days prior through 2 days after the first positive blood culture. Calculation of the area under the receiver operating characteristic (ROC) curve confirmed that APACHE II and SAPS II at day -1 and SOFA at day +1 were better predictors of outcome than days -2, 0 and day 2 of BSI. By stepwise logistic regression analysis of these three scoring systems, SAPS II (OR: 13.03, CI95% 2.51-70.49) and APACHE II (OR: 12.51, CI95% 3.12-50.09) on day -1 were the best predictors for mortality. SAPS II and APACHE II are more accurate than the SOFA score for predicting mortality in this group of patients at day -1 of BSI.

Severity of Illness Index

Intensive Care Units

Hospital Mortality

Cross Infection - physiopathology

Humans

Middle Aged

Cross Infection - mortality

Bacteremia - physiopathology

Bacteremia - mortality

Male

Pseudomonas Infections - mortality

Pseudomonas Infections - microbiology

Bacteremia - microbiology

Pseudomonas Infections - physiopathology

Cross Infection - microbiology

Aged, 80 and over

Adult

Female

Pseudomonas aeruginosa

ROC Curve

Aged

APACHE

Details

Title: Subtitle: Comparison of severity of illness scoring systems for patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa
Creators: Alexandre R Marra - Division of Infectious Diseases, Universidade Federal de São Paulo, Brasil (UNIFESP-EPM)/Hospital São Paulo (HSP), Brazil. a.marra@uol.com.br
Gonzalo M L Bearman
Richard P Wenzel
Michael B Edmond
Resource Type: Journal article
Publication Details: BMC infectious diseases, Vol.6(1), 132
DOI: 10.1186/1471-2334-6-132
PMID: 16916466
PMCID: PMC1563469
NLM abbreviation: BMC Infect Dis
ISSN: 1471-2334
eISSN: 1471-2334
Publisher: England
Language: English
Date published: 08/17/2006
Academic Unit: Internal Medicine
Record Identifier: 9983905518702771

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