Severity and predicted outcome of postoperative Pseudomonas aeruginosa infections

• Published in: Surgery today (Tokyo, Japan) Vol. 25; no. 8; p. 672
• Main Authors: Kodama, T, Yokoyama, T, Takesue, Y, Okita, M, Nakamitsu, A, Hiyama, E, Imamura, Y, Santo, T, Murakami, Y, Tsumura, H
• Format: Journal Article
• Language: English
• Published: Japan 01.08.1995
• Subjects: Adult; Aged; Female; Humans; Male; Middle Aged; Postoperative Complications - diagnosis; Postoperative Complications - microbiology; Postoperative Complications - mortality; Predictive Value of Tests; Prognosis; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - diagnosis; Pseudomonas Infections - microbiology; Pseudomonas Infections - mortality; Severity of Illness Index
• ISSN: 0941-1291
• DOI: 10.1007/BF00311481

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.