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Description

Aydogdu and Gursel identified risk factors for septic shock in a patient with ventilator-associated pneumonia (VAP). These can help to identify a patient who may benefit from more aggressive management. The authors are from Gazi University in Ankara, Turkey.


Patient selection: ventilator-associated pneumonia

 

Outcome: septic shock

 

Parameters:

(1) age

(2) modified clinical pulmonary infection score (CPIS) of Luna et al (integers from 0 to 10)

(3) serum glucose in mg/dL

(4) absolute lymphocyte count

 

Parameter

Finding

Points

serum glucose

<= 120 mg/dL

0

 

> 120 mg/dL

1

absolute lymphocyte count

>= 1,000 per µL

0

 

< 1,000 per µL

1

 

The CPIS was 8.3 +/- 1.7 for patients with septic shock versus 7.4 +/- 1.5 for non-septic shock. In the implementation a CPIS >= 8 will be used as a risk factor.

 

For age patients with septic shock had ages 76 +/- 10 versus 69 +/- 14 for those without septic shock. An age >= 75 will be used in the implementation.

 

total number of risk factors =

= SUM(points for risk factors)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

• The greater the number of risk factors the greater the risk of septic shock.

 

Limitations:

• The study requires validation in a prospective trial.


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