Journal Article

Predicting Mortality in Patients with Ventilator-Associated Pneumonia: The APACHE II Score versus the New IBMP-10 Score

Mehdi Mirsaeidi, Paula Peyrani and Julio A. Ramirez

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 49, issue 1, pages 72-77
Published in print July 2009 | ISSN: 1058-4838
Published online July 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/599349
Predicting Mortality in Patients with Ventilator-Associated Pneumonia: The APACHE II Score versus the New IBMP-10 Score

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Background. Ventilator-associated pneumonia (VAP) is the leading cause of mortality associated with nosocomial infection. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at the time of diagnosis of VAP is considered the best scoring system to predict mortality in patients with VAP. The objective of this study was to develop a simple score to predict mortality in patients with VAP and to compare its results with those for the APACHE II scoring system.

Methods. The new score was developed by performing a univariate analysis of data collected from 178 patients with VAP. The mortality prediction ability of the new score was compared with the APACHE II score on the basis of receiver operating characteristic curve analysis.

Results. The IBMP-10 score assigned 1 point to each of the following variables: (1) the presence of i mmunodeficiency; (2) b lood pressure <90 mm Hg (systolic) or <60 mm Hg (diastolic); (3) m ultilobar infiltrates noted on a chest radiograph; (4) p latelet count, <100,000/mm3; and (5) duration of hospitalization before the onset of VAP of >10 days. The area under the curve was 0.743 for the APACHE II score and 0.824 for the IBMP-10 score (P <.001).

Conclusions. This preliminary work indicates that a 5-point score, the IBMP-10, is comparable to the APACHE II score in its ability to predict mortality in patients with VAP. If future studies validate the IBMP-10 score, physicians may be have a simple tool to evaluate the disease severity and to predict outcomes in patients with VAP.

Journal Article.  2511 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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