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Severity and predicted outcome of postoperative Pseudomonas aeruginosa infections
T Kodama1, T Yokoyama, Y Takesue
1First Department of Surgery, Hiroshima University School of Medicine, Japan.
Abstract:
The severity and predicted outcome of postoperative Pseudomonas aeruginosa (P. aeruginosa) infections (PPAI) was evaluated using a severity scoring system based on a simplification and modification of the APACHE II system. A total of 86 patients in whom P. aeruginosa was isolated from various sources were examined. PPAI developed in 50 patients, resulting in an overall mortality rate of 24%. An increased severity score (SS) correlated with an increased risk of developing PPAI. Thus, PPAI developed in 33% of the patients with an SS of 0-1, in 66.7% of those with an SS of 2-3, and in 100% of those with an SS of 6 or higher. Moreover, the mortality rate of the patients with an initial score of 6 or higher was 50%. The mean (+/- SD) initial severity score was 5.4 +/- 2.9 for survivors and 2.9 +/- 2.6 for nonsurvivors (P < 0.01). In the patients who subsequently died, the SS remained high throughout the clinical course despite therapy, whereas in the survivors the SS decreased progressively, reflecting a favorable clinical course. These results suggest that our severity scoring system was useful for predicting outcome and monitoring the response of PPAI to therapy.
Insights
A modified APACHE II severity scoring system effectively predicts outcomes for postoperative Pseudomonas aeruginosa infections. Higher scores indicate increased risk and mortality, while decreasing scores suggest a favorable treatment response.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Medical Informatics
Background:
- Postoperative Pseudomonas aeruginosa infections (PPAI) pose significant risks.
- Accurate prediction of PPAI outcomes and patient prognosis is crucial for effective management.
Purpose of the Study:
- To evaluate a modified APACHE II severity scoring system for predicting outcomes in PPAI.
- To assess the utility of the severity score in monitoring patient response to therapy.
Main Methods:
- A modified APACHE II severity scoring system was developed and applied.
- 86 patients with P. aeruginosa isolated from various sources were analyzed.
- Correlation between severity scores and PPAI development, mortality, and clinical course was examined.
Main Results:
- PPAI developed in 50 patients, with an overall mortality rate of 24%.
- Increased severity scores correlated significantly with higher PPAI risk and mortality rates.
- Mean initial severity scores were significantly higher in non-survivors (5.4) compared to survivors (2.9).
- Severity scores decreased in survivors and remained high in non-survivors, indicating treatment response.
Conclusions:
- The modified severity scoring system is a valuable tool for predicting PPAI outcomes.
- The system aids in monitoring therapeutic response and patient prognosis in PPAI cases.