Severity and predicted outcome of postoperative Pseudomonas aeruginosa infections |
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Authors: | Takashi Kodama Takashi Yokoyama Yoshio Takesue Mitsuaki Okita Atsushi Nakamitsu Eiso Hiyama Yuji Imamura Takahiro Santo Yoshiaki Murakami Hiroaki Tsumura Kanae Shinbara Katsunari Miyamoto Naokuni Tatsumoto Yuichirou Matsuura |
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Institution: | (1) First Department of Surgery, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, 734 Hiroshima, Japan;(2) Department of General Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, 734 Hiroshima, Japan |
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Abstract: | The severity and predicted outcome of postoperative Pseudomonas aeruginosa (P. aeruginosa) infections (PPAI) was evaluated using a severity scoring system based on a simplification and modification of the APACHE II system. A total of 86 patients in whom P. aeruginosa was isolated from various sources were examined. PPAI developed in 50 patients, resulting in an overall mortality rate of 24%. An increased severity score (SS) correlated with an increased risk of developing PPAI. Thus, PPAI developed in 33% of the patients with an SS of 0–1, in 66.7% of those with an SS of 2–3, and in 100% of those with an SS of 6 or higher. Moreover, the mortality rate of the patients with an initial score of 6 or higher was 50%. The mean (±SD) initial severity score was 5.4±2.9 for survivors and 2.9±2.6 for nonsurvivors (P<0.01). In the patients who subsequently died, the SS remained high throughout the clinical course despite therapy, whereas in the survivors the SS decreased progressively, reflecting a favorable clinical course. These results suggest that our severity scoring system was useful for predicting outcome and monitoring the response of PPAI to therapy. |
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Keywords: | postoperative infection Pseudomonas aeruginosa severity of illness prediction of outcome severity score |
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