Apache II score as a predictor of the type or virulence of sepsis

ABSTRACT

A variety of systems for assessing severity of illness in critically ill patients have been described. The APACHE II [acute physiology and chronic health evaluation] is used widely for predicting probability of hospital mortality. We have looked, in our retrospective review, at the correlation between APACHE II scores of patients admitted to our Intensive care unit [ICU] within twenty four hours and the development and type of infection as well as evidence of hemodynamic involvement [i.e. presence of sepsis] as outlined by the criteria described for systemic inflammatory response syndrome [SIRS]. As evidenced by following these patients with increased APACHE II scores and their cultures, we found that many of them had moderate to severe signs and symptoms of sepsis including hemodynamic complications, increased respiratory rate, temperature changes and mental status changes. They were also eventually found to be culture positive for organisms like Candida, Methicillin-resistant Staphylococcus aureus [MRSA], Pseudomonas sp., E. coli, and Klebsiella sp. in the blood, tracheal cultures and urine -organisms possibly virulent in compromised patients even though these patients were intubated and catheterized