Comparing Scoring Systems for Bloodstream Infections
Author Information
Author(s): Marra Alexandre R, Bearman Gonzalo ML, Wenzel Richard P, Edmond Michael B
Primary Institution: Virginia Commonwealth University Medical Center
Hypothesis
Which severity of illness scoring system best predicts mortality in patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa?
Conclusion
SAPS II and APACHE II are more accurate than the SOFA score for predicting mortality in this group of patients at day -1 of BSI.
Supporting Evidence
- The crude mortality rate for P. aeruginosa BSI was found to be 47.6%.
- SAPS II had the best sensitivity at 93.3%, while APACHE II had the best specificity at 87.9%.
- The study included only monomicrobial bloodstream infections in ICU patients.
Takeaway
Doctors used three scoring systems to see which one could best predict if patients with a certain infection would survive. They found two scores worked better than the third.
Methodology
A historical cohort study was performed on 63 adults in intensive care units with P. aeruginosa monomicrobial nosocomial bloodstream infection.
Limitations
The study is retrospective, applied scoring systems daily despite their intended use after 24 hours of ICU care, and is limited to a single center.
Participant Demographics
Mean age of participants was 56 years, with 60% male and various underlying conditions.
Statistical Information
Confidence Interval
CI95% 2.51–70.49 for SAPS II; CI95% 3.12–50.09 for APACHE II
Digital Object Identifier (DOI)
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