APACHE Ⅱ and CPIS scores in predicting prognosis in patients with ventilator-associated pneumonia / 重庆医科大学学报

ABSTRACT

Objective:To assess the value of the APACHE Ⅱ and CPIS in the prediction of mortality during VAP episodes in pulmonary patients.Methods:APACHE Ⅱ and CPIS scores were recorded on the day of the diagnosis of VAP for 58 patients.The primary outcome endpoint was the ICU mortality.Hosmer-Lemeshow goodness of fit tests and ROC curves were used to estimate the predictive calibration and resolution of the scoring systems.Results:Mortality rate was 43.1%.The mean APACHE Ⅱ(t = 3.797,P = 0.000 1)and CPIS scores(t = 3.462,P = 0.001)determined at the time ofVAP diagnosis were significantly higher in nonsurvivors than in survivors.In 33 survival patients,the mechanical ventilation time,the ICU stay time and the hospitalization time was positively correlated with APACHE Ⅱ,so as to CPIS score.Calibration was excellent for APACHE Ⅱ(?2 = 1.546,P = 0.845)and CPIS(?2 =1.341,P = 0.911);Resolution was good for APACHE Ⅱ and acceptable for CPIS,but APACHE Ⅱ was even more better.Conclusion:These results suggest that APACHE Ⅱ and CPIS scoring system also have a good calibration for predicting mortality in patients with ventilator-associated pneumonia,but APACHE Ⅱ has a better resolution.