Evaluation of nosocomial infection risk using APACHE II scores in the neurological intensive care unit.
To evaluate the feasibility and accuracy of using the Acute Physiology, Age and Chronic Health Evaluation II (APACHE II) scoring system for predicting the risk of nosocomial infection in the neurological intensive care unit (NICU), 216 patients transferred to NICU within 24hours of admission were retrospectively evaluated. Based on admission APACHE II scores, they were classified into three groups, with higher APACHE II scores representing higher infectious risk. The device utilization ratios and device-associated infection ratios of NICU patients were analyzed and compared with published reports on patient outcome. Statistical analysis of nosocomial infection ratios showed obvious differences between the high-risk, middle-risk and low-risk groups (p<0.05). The area under the receiver operating characteristic curve of the APACHE II model in predicting the risk of nosocomial infection was 0.81, which proved to be reliable and consistent with the expectation. In addition, we found statistical differences in the duration of hospital stay (patient-days) and device utilization (device-days) between different risk groups (p<0.05). Thus the APACHE II scoring system was validated in predicting the risk of nosocomial infection, duration of patient-days and device-days, and providing accurate assessment of patients' condition, so that appropriate prevention strategies can be implemented based on admission APACHE II scores.
Department of Neurology, Beijing Shunyi Hospital Affiliated to China Medical University, Shunyi District, Beijing, China; Department of Neurology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Gongti Southern Ro. 8, Chaoyang District, 100020 Beijing, China.
Hai-Ying
HY
Li
Department of Neurology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Gongti Southern Ro. 8, Chaoyang District, 100020 Beijing, China.
Shu-Juan
SJ
Li
Department of Physiology and Pathophysiology, Peking University Health Science Center, Haidian District, Beijing, China.
Nan
N
Yang
Department of Neurology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Gongti Southern Ro. 8, Chaoyang District, 100020 Beijing, China. Electronic address: Huwenli@sina.com.
Wen-Li
WL
Hu
D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002404:Catheterization / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009462:Neurology; D012372:ROC Curve; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D012306:Risk; D012680:Sensitivity and Specificity; D055815:Young Adult
APACHE II; Neurological intensive care unit; Nosocomial infection; Risk predicting