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.
