BACKGROUND: Nosocomial infections affect more than 2 million patients annually in the United States at a cost of $4.5 billion. The aim of this study is to identify the role of the APACHE II score and the Injury Severity Scale (ISS) as independent predictors of nosocomial infections in trauma patients admitted to the intensive care unit (ICU). METHODS: A retrospective chart review of 113 trauma patients admitted to the ICU was conducted by an infectious disease physician. Demographic data and incidence of nosocomial infections were recorded. Multivariate logistic regression analysis was used to determine variables that are predictive of the occurrence of nosocomial infections. RESULTS: Presence or absence of intubation, ICU length of stay, APACHE II score, and ISS were related to the presence of infections; however, only the ICU length of stay was an independent predictor of a nosocomial infection, with an odds ratio of 1.81. By linear regression, 17% of the variance in the ICU duration of stay was a result of the APACHE II score in patients with a score >/=5. CONCLUSION: APACHE II score and ISS score were not good predictors of the incidence of nosocomial infections in trauma patients admitted to the ICU, but the APACHE II score has a modest correlation with the duration of stay in the ICU. A stratified cohort study could identify the subset of patients for which the APACHE II score predicts a prolonged stay in the ICU, thus an increased risk of infection.
BACKGROUND:Nosocomial infections affect more than 2 million patients annually in the United States at a cost of $4.5 billion. The aim of this study is to identify the role of the APACHE II score and the Injury Severity Scale (ISS) as independent predictors of nosocomial infections in traumapatients admitted to the intensive care unit (ICU). METHODS: A retrospective chart review of 113 traumapatients admitted to the ICU was conducted by an infectious disease physician. Demographic data and incidence of nosocomial infections were recorded. Multivariate logistic regression analysis was used to determine variables that are predictive of the occurrence of nosocomial infections. RESULTS: Presence or absence of intubation, ICU length of stay, APACHE II score, and ISS were related to the presence of infections; however, only the ICU length of stay was an independent predictor of a nosocomial infection, with an odds ratio of 1.81. By linear regression, 17% of the variance in the ICU duration of stay was a result of the APACHE II score in patients with a score >/=5. CONCLUSION: APACHE II score and ISS score were not good predictors of the incidence of nosocomial infections in traumapatients admitted to the ICU, but the APACHE II score has a modest correlation with the duration of stay in the ICU. A stratified cohort study could identify the subset of patients for which the APACHE II score predicts a prolonged stay in the ICU, thus an increased risk of infection.
Authors: Khalid Almahmoud; Rami A Namas; Othman Abdul-Malak; Akram M Zaaqoq; Ruben Zamora; Brian S Zuckerbraun; Jason Sperry; Andrew B Peitzman; Timothy R Billiar; Yoram Vodovotz Journal: Shock Date: 2015-08 Impact factor: 3.454
Authors: Julia Brenmoehl; Hans Herfarth; Thomas Glück; Franz Audebert; Stefan Barlage; Gerd Schmitz; Dieter Froehlich; Stefan Schreiber; Jochen Hampe; Jürgen Schölmerich; Ernst Holler; Gerhard Rogler Journal: Intensive Care Med Date: 2007-06-09 Impact factor: 17.440
Authors: Marianna Almpani; Amy Tsurumi; Thomas Peponis; Yashoda V Dhole; Laura F Goodfield; Ronald G Tompkins; Laurence G Rahme Journal: PLoS One Date: 2020-04-29 Impact factor: 3.240