Comparison of APACHE II, MPM and CPIS Scoring Systems with Regard to Determine of Mortality at Ventilator-Associated Pneumonia
Ismail Sırıt
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
Hülya Sungurtekin
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
Simay Serin
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
Ercan Gürses
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
Turan Evran
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
Asli Mete
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
Ibrahim Öztürk
Department of Anesthesiology and Reanimation, Medical Faculty, Pamukkale University, Turkey.
*Author to whom correspondence should be addressed.
Abstract
Aims: Ventilator-associated pneumonia (VAP) due to mechanical ventilation is an important issue that increases mortality and cost of treatment. In this study, we aimed to compare the effectiveness of three scoring models for estimation of mortality and morbidity in patients with ventilator associated pneumonia.
Study Design: Prospective research.
Place and Duration of Study: Patients with VAP who were admitted into intensive care unit Pamukkale University Hospital prospectively included in the study between January 2012 and June 2012.
Methodology: Demographical data, diagnosis on admission, departments from where admitted, APACHE II, Mortality Probability Model II0 (MPMII0) and Mortality Probability Model II24 (MPMII24) scores on admission, length of stay in intensive care and hospital, duration of mechanical ventilation, microbiological data for pneumonia, outcome and Clinical Pulmonary Infection Score values on day 1, 3, 5 and 7 were recorded.
Results: Eighty patients (F/M: 37/43) were included study. Mortality was 67.5%. MPM II0, MPMII24 values were significantly high in patients who has died but ROC curves were not significant for any of the scoring systems. In addition, relationship between scoring models and mortality, duration of mechanical ventilation, length of stay in intensive care and hospital was not statistically significant (P=.05).
Conclusion: We concluded that each of the three scoring systems for the prediction of mortality in VAP was not superior to each other.
Keywords: Ventilator-associated pneumonia, mortality probability model II, APACHE II, clinical pulmonary infection score