Severity of illness classification for infection control departments: a study in nosocomial pneumonia.
BACKGROUND
A subjective severity of illness classification was evaluated in a study of nosocomial pneumonia. This is a 5-category system based on the determination of the control of underlying illness and the risk of death during current hospital admission.


METHODS
A case-control study was performed with 128 cases of nosocomial pneumonia and 252 control patients. An additional 60 case and 90 control patients were used to compare this classification with APACHE II scoring in intensive care unit patients.


RESULTS
In univariate analysis, the severity illness classification was significantly associated with nosocomial pneumonia risk (p < 0.01). APACHE II adequately predicted mortality rate but was not statistically significantly associated with nosocomial pneumonia risk among intensive care unit patients. In logistic regression analysis, the severity of illness classification, surgery, age, nasogastric tube placement, and histamine blockers each showed significant independent association with nosocomial pneumonia.


CONCLUSIONS
The role of the severity of illness classification for risk stratification in nosocomial pneumonia is valid. Its roles in the evaluation of surgical wound infection, nosocomial bacteremia, and quality of care remain to be determined in subsequent studies.
Salemi
C
C
Department of Infection Control, Kaiser Permanente Medical Center, Fontana, CA 92335.
Morgan
J W
JW
Kelleghan
S I
SI
Hiebert-Crape
B
B
D002140:California; D016022:Case-Control Studies; D003428:Cross Infection / Q000145:classification*; D006279:Health Maintenance Organizations; D006748:Hospital Departments; D006801:Humans; D017053:Infection Control; D011014:Pneumonia / Q000145:classification*; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index