ABSTRACT
Objective:To study the application of modified clinical pneumonia infection score (CPIS-LUS) in the diagnosis of ventilator-associated pneumonia (VAP).Methods:The clinical data of 208 VAP patients admitted to Shaoxing Second Hospital from January 2018 to January 2020 were analyzed. The patients were divided into low-risk group (69 cases), medium-risk group (81 cases) and high-risk group (58 cases) according to acute physiological and chronic health evaluation scoreⅡ.Meanwhile the patients were divided into improvement group (141 cases) and the deterioration group (67 cases) according to the treatment outcome. One hundred and sixty-five patients who received mechanical ventilation treatment but without VAP was as non-VAP group. The scores of CPIS-LUS among the groups were compared.Results:At the initial mechanical ventilation, the CPIS-LUS scores of the VAP group and the non-VAP group had no statistical significant ( P>0.05). At the time of diagnosis, the CPIS-LUS scores in VAP group was higher than that at the initial ventilation with: (6.09 ± 0.81) scores vs. (3.79 ± 0.48) scores, and was higher than that in the non-VAP group with: (6.09 ± 0.81) scores vs. (3.71 ± 0.43) scores, the differences were statistically significant ( P<0.05). The CPIS-LUS scores in the high-risk group was higher than that in the medium-risk group and the low-risk group: (7.85 ± 1.08) scores vs. (5.85 ± 0.76) , (4.89 ± 0.64) scores, the CPIS-LUS scores in the medium-risk group was also higher than that in the low-risk group with: (5.85 ± 0.76)scores vs. (4.89 ± 0.64) scores, the differences were statistically significant ( P<0.05). At the initial mechanical ventilation, the CPIS-LUS scores of the improvement group and the deterioration group were (3.76 ± 0.47), (3.85 ± 0.50) scores, there was no statistical difference ( P>0.05). At the time of diagnosis, the CPIS-LUS scores of the improvement group and the deterioration group were higher than those of the initial mechanical ventilation, and the CPIS-LUS scores of the improvement group was lower than that of the deterioration group: (5.43 ± 0.67)scores vs. (7.48 ± 1.10) scores, the differences were statistically significant ( P<0.05). At anti-infection treatment for 7 d, the improvement group CPIS-LUS score was lower than that at the time of diagnosis: (3.69 ± 0.41) scores vs. (5.43 ± 0.67) scores, P<0.05, but the CPIS-LUS scores in the deterioration group was not decreased. Conclusions:The CPIS-LUS score can assist early diagnosis of VAP, and can be used as an effective predictor of disease severity and prognosis, and provide reference for antibiotic treatment.