Prediction of the Risk of Hospital Deaths in Patients with Hospital-Acquired Pneumonia Caused by Multidrug-Resistant
Hongmei Shu1,2,3, Lijuan Li2, Yimin Wang2
1Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital Capital Medical University, Beijing, People's Republic of China.
Purpose:
To predict the risk of hospital deaths in patients with hospital-acquired pneumonia (HAP) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) infection.
Patients And Methods:
A total of 366 patients who were diagnosed with HAP caused by MDR-AB infection were enrolled between January 2013 and December 2016. The sociological characteristics and clinical data of these cases were collected. Univariate and multivariate logistic analyses were used to explore the risk factors of hospital deaths before medication and after drug withdrawal. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were utilized to assess the predictive effectiveness of the models with or without the adjustment.
Results:
Hospital deaths occurred in 142 cases (38.80%). The results showed that acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores before medication and after drug withdrawal were associated with the risk of hospital deaths. Adjusting the covariants including the age, autoimmune disease, venous cannula, transfer of patients from other hospitals, and APACHE II score at admission, then no differences were discovered in predicting the hospital deaths between adjusted APACHE II and adjusted SOFA scores before medication (AUC: 0.808 vs 0.803, P =0.614) and after drug withdrawal (AUC: 0.876 vs 0.878, P =0.789).
Conclusion:
Before medication or after drug withdrawal, the adjusted APACHE II and adjusted SOFA scores all performed well in determining the predictive effectiveness of the hospital deaths in patients with HAP caused by MDR-AB infection, indicating that the appropriate infection control may reduce the occurrence of nosocomial deaths and improve the prognosis.
Insights
Predicting hospital deaths in multidrug-resistant Acinetobacter baumannii hospital-acquired pneumonia (HAP) is crucial. Adjusted APACHE II and SOFA scores effectively predict mortality risk, aiding prognosis and infection control strategies.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Public Health
Background:
- Hospital-acquired pneumonia (HAP) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) presents a significant challenge.
- Predicting mortality in these patients is essential for effective management and resource allocation.
Purpose of the Study:
- To predict the risk of hospital deaths in patients with HAP caused by MDR-AB infection.
- To evaluate the predictive performance of APACHE II and SOFA scores in this patient population.
Main Methods:
- A cohort of 366 patients with MDR-AB HAP was analyzed.
- Sociological characteristics and clinical data were collected.
- Univariate and multivariate logistic analyses, ROC curves, and AUC were used to assess risk factors and predictive models.
Main Results:
- Hospital deaths occurred in 38.80% of patients.
- Both APACHE II and SOFA scores, before and after medication, were associated with hospital death risk.
- Adjusted APACHE II and SOFA scores demonstrated comparable predictive effectiveness (AUCs ranging from 0.808 to 0.878).
Conclusions:
- Adjusted APACHE II and SOFA scores are reliable predictors of hospital mortality in MDR-AB HAP.
- Effective infection control measures are vital for reducing nosocomial deaths and improving patient outcomes.
More Related Videos
07:59Rapid and Specific Detection of Acinetobacter baumannii Infections Using a Recombinase Polymerase Amplification/Cas12a-based System
Published on: April 25, 2025
07:27Methods for Detecting Cytotoxic Amyloids Following Infection of Pulmonary Endothelial Cells by Pseudomonas aeruginosa
Published on: July 12, 2018
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...