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.
Kodama
T
T
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Yokoyama
T
T
Takesue
Y
Y
Okita
M
M
Nakamitsu
A
A
Hiyama
E
E
Imamura
Y
Y
Santo
T
T
Murakami
Y
Y
Tsumura
H
H
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