Bueno-Cavanillas et al evaluated the use of severity indices to predict nosocomial infection in patients admitted to the intensive care unit (ICU). The study was done at the University of Granada Hospital in Spain.
Apache II: A score > 12 showed a positive correlation with nosocomial infection, but this disappeared on multivariate analysis.
Therapeutic Intervention Scoring System (TISS):
(1) A score > 20 correlated with risk of nosocomial infection, but this was found significant only for the first 7 days of the ICU stay on multivariate analysis.
(2) It is stated in the abstract that each TISS point suggests an infection risk increment of 6%; I could not find a discussion on this topic in the text. The risk may be for each TISS point > 20.
The risk of nosocomial infection increased as the length of the ICU stay increased.
For ICU stays of <= 7 days
TISS
Relative Risk Nosocomial Infection
95% CI
<= 20
1
21 - 30
3.5
1.26 - 9.78
>= 31
4.88
1.57 - 15.1
For ICU stays > 7 days
Length of Stay
Relative Risk Nosocomial Infection
95% CI
8 - 14 days
7.08
4.26 - 11.76
>= 15 days
13.84
8.79 - 21.78
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