Severity and predicted outcome of postoperative Pseudomonas aeruginosa infections.
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.
First Department of Surgery, Hiroshima University School of Medicine, Japan.
T
T
Kodama
T
T
Yokoyama
Y
Y
Takesue
M
M
Okita
A
A
Nakamitsu
E
E
Hiyama
Y
Y
Imamura
T
T
Santo
Y
Y
Murakami
H
H
Tsumura
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012720:Severity of Illness Index