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Description

Lisboa et al developed the PIRO (predisposition, infection, response, organ dysfunction) score for predicting the risk of ventilation-associated pneumonia (VAP) in a mechanically ventilated patient in the intensive care unit (ICU). The score correlates with mortality and use of healthcare resources. The authors are from Joan XXIII University Hospital in Tarragona, Spain.


Parameters:

(1) predisposition (comorbid conditions)

(2) infection (bacteremia)

(3) response (systolic blood pressure)

(4) organ dysfunction (ARDS)

 

Parameter

Finding

Points

comorbid conditions

none

0

 

one or more of: COPD, CHF, chronic liver disease, immunocompomised status, chronic renal failure

1

bacteremia

absent

0

 

present

1

systolic blood pressure

>= 90 mm Hg

0

 

< 90 mm Hg

1

ARDS

absent

0

 

present

1

 

total VAP PIRO score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• The higher the score the greater the risk for developing VAP.

 

Total VAP PIRO Score

Risk of VAP

Mortality Rate

0

low

10 %

1

low

17%

2

high

53%

3

very high

77%

4

very high

93%

 


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